home Auditorium 7 ARVI with abdominal syndrome in children. Viral infection with abdominal syndrome: causes and treatment

ARVI with abdominal syndrome in children. Viral infection with abdominal syndrome: causes and treatment

Any pain is an alarming signal that indicates the appearance of some problems in the body’s functioning. Accordingly, this kind of unpleasant sensation should not be ignored. This is especially true for symptoms that develop in children, since they can indicate serious disturbances in the body’s functioning, including those that require emergency care. Enough common symptom This kind of pain is considered to be abdominal pain syndrome, in other words, pain in the abdomen. Let's talk about the variety and specificity of complaints of this kind in a little more detail.

Abdominal pain syndrome in children often becomes the reason for parents to contact doctors, and can become an indication for hospitalization in inpatient department. The appearance of such an unpleasant phenomenon can be explained by a variety of factors - from ARVI to surgical pathologies.

Diagnostics

In the last ten years, the main assistance in clarifying and even establishing the correct diagnosis for abdominal pain syndrome in pediatric practice has been provided by ultrasound examination of the peritoneal organs, as well as the retroperitoneal space.

No special preparatory measures are required to perform an ultrasound. Children usually skip one feeding. In children younger age You should pause for three to four hours; schoolchildren under ten years old will have to fast from four to six hours, and older ones - about eight hours. If it is not possible to perform an ultrasound in the morning on an empty stomach, it can be performed later. However, at the same time, it is worth excluding certain foods from the child’s diet - creamy and vegetable oil, eggs, fruits and vegetables, dairy products, seeds and various things frankly junk food. In the morning, you can give the patient some lean boiled meat or fish, buckwheat porridge and some unsweetened tea.

Causes

Abdominal syndrome in children at an early age it can be provoked excessive gas formation– flatulence, which causes intestinal colic. IN in rare cases such a nuisance is fraught with the development of intussusception, requiring immediate hospitalization. In addition, at an early age, ultrasound helps to detect abnormalities in the structure of organs.

In school-age children, complaints of abdominal pain are often a sign of a chronic type of gastroduodenitis. In addition, they may indicate dyskinesia and reactive changes pancreas. In this case, the doctor will select the appropriate treatment for the child, which will eliminate the symptoms and lead to recovery.

Among other things, quite often abdominal pain syndrome in children develops due to acute or chronic illnesses kidneys or bladder. Accordingly, an examination of the urinary system also plays an important role. Ultrasound of these organs is performed twice - with a well-filled bladder and soon after it is emptied.

It is also necessary to take into account the fact that abdominal pain may be a consequence of the development menstrual cycle. In this case, their appearance is often explained by the occurrence functional cysts ovaries, which require systematic ultrasound monitoring, and usually disappear on their own.

Acute painful sensations in the abdomen, which develop at night, often cause the child to be hospitalized in the surgery department, where he undergoes a mandatory ultrasound. So, such a symptom is often explained by the appearance of acute surgical pathology, for example, acute appendicitis, intestinal obstruction (mechanical or dynamic type), intussusception, etc. Such conditions require immediate surgical intervention.

Sometimes nighttime abdominal pain indicates the appearance of changes internal organs that can be corrected conservative methods and do not require hospitalization.

In rare cases, the occurrence of pain may also indicate the development of neoplasms. Such diseases require prompt diagnosis and immediate treatment. Ultrasound and a number of other studies will again help to identify them.

Treatment

Treatment of abdominal pain syndrome in children depends directly on the causes of its development. Parents are strongly discouraged from making their own decisions and giving their children any painkillers, antispasmodics, etc., since such a practice is fraught with serious consequences. It’s better to play it safe and once again seek doctor’s help.

Additional Information

With the development of abdominal pain syndrome in pediatric practice, the main difficulty for correct diagnosis It is difficult for the baby to describe his sensations, the localization of pain, their intensity and irradiation. According to doctors, young children very often describe any discomfort occurring in the body as abdominal pain. A similar situation occurs when trying to describe a feeling of dizziness, nausea, or pain in the ears or head that is incomprehensible to a child. It is extremely important to take into account that pain in the abdominal area can also manifest itself in many pathological conditions, such as diseases of the lungs or pleura, heart and kidneys, as well as lesions of the pelvic organs.

is a complex of symptoms that primarily manifests itself as abdominal pain. The main reasons for the development of the syndrome are spasms of certain parts gastrointestinal tract or overstretching of the biliary tract. Abdominal syndrome also causes bloating.

Causes of abdominal syndrome

The appearance of unpleasant symptoms is provoked by:

passive lifestyle;
stress;
poor nutrition;
taking antibiotics;
intestinal disease and others.

Quite often the appearance of pain is provoked by spasms resulting from allergic reaction, irritation of the phrenic nerves, irradiation of pain from the pleura or pericardium.

If the cause of abdominal ischemic pain syndrome is vasculitis and periarteritis, then such unpleasant symptom, like blood in the stool, the cause of this is hemorrhage into the intestinal wall.

In addition, the syndrome itself can become a sign of a disease. Thus, ARVI with abdominal syndrome indicates that the disease is progressing to a more complex stage and can lead to febrile convulsions, hemorrhagic phenomena or chronic diseases.

Symptoms of abdominal syndrome

Abdominal pain syndrome is characterized by intermittent pain, the localization of which is difficult to determine.

The disease is also accompanied by:

vomiting;
muscle tension in the anterior abdominal wall;
changes in the cellular composition of the blood, that is, leukocytosis.

Experts distinguish two types of pain:

Acute abdominal syndrome. It has a short duration and most often develops quickly.
Chronic abdominal pain syndrome. It is characterized by a gradual increase in pain that can recur over months.

The syndrome is also divided into:

visceral;
parental;
reflected;
psychogenic.

Visceral pain occurs as a result of increased pressure in the hollow organ or stretching of its wall; also factors in the development of pain include:

mesenteric tension;
vascular disorders;
stretching of the capsule of parenchymal organs.

Somatic pain results from the presence of pathological processes in the parietal peritoneum and tissues.

Abdominal reflected mechanism syndrome is localized in various anatomical areas, which can be significantly distant from the pathological focus. This pain occurs when a stone passes or an organ is damaged.

The cause of psychogenic pain is often depression, which in the first stages may not be noticed even by the patient himself. Stress and prolonged depression trigger a biochemical process that provokes the development of psychogenic pain.

Often one form of pain flows into another. Thus, with increased pressure in the intestines, visceral pain occurs, which subsequently flows into reflected pain in the back.

Thus, abdominal syndrome has a fairly extensive list of manifestations that signal the presence of pathologies in the body.

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What is abdominal syndrome called? Treatment of abdominal syndrome

Abdominal syndrome in medicine is usually called a complex of symptoms, the main criterion for which is abdominal pain. It should be immediately noted that it often does not have a direct connection with any surgical pathology, but is caused either by diseases of the organs located in the abdominal cavity, or problems with the patient’s nervous system, the condition of his lungs and heart. This pain can also be provoked by an inflammatory process in the peritoneum caused by exposure to toxic substances, and its stretching by a diseased organ.

In what cases does abdominal syndrome develop?

Abdominal pain syndrome has a rather complex classification. Conventionally, it can be correlated with the diseases against which it manifests itself.

These may be diseases of the digestive system - hepatitis, cirrhosis of the liver, pyloric stenosis duodenum and so on.
The mentioned abdominal pains can also accompany organ pathologies chest– pneumonia, myocardial infarction, diverticulosis of the esophagus, etc.
The manifestation of abdominal syndrome has also been observed in infectious or viral diseases - syphilis, herpes zoster, etc.

IN special group pathological conditions forming the development of the described pathology, it is necessary to include diseases caused by metabolic disorders or immune system – diabetes, rheumatism and porphyria.

How pain manifests itself under various factors

Abdominal pain syndrome is distinguished depending on the type of pain. It is this sign that often helps specialists make the correct diagnosis and establish the cause of the disease. This is done through a thorough examination of the patient, biochemical analysis blood, ultrasound results, as well as x-rays of the chest and abdominal cavity.

There are spastic pains that arise and disappear suddenly, having the character of a painful attack. They often radiate to the back, under the shoulder blade, in the lower back or lower limbs and are accompanied by nausea, vomiting, forced positioning, etc. As a rule, they are provoked by inflammatory processes in the abdominal cavity, poisoning or dysfunction of the gastrointestinal tract.
If the syndrome is caused by stretching of hollow organs, then the pain becomes aching and pulling.
And when structural changes or organ damage, peritoneal pain appears. In medicine they are considered the most dangerous and are combined common name « acute stomach" Such pain appears suddenly, it is diffuse, accompanied by general malaise and severe vomiting. It gets worse when you change position, move or cough.
Referred pain occurs during pneumonia, heart attack, pleurisy, etc. During such attacks, pain caused by a disease of an organ located outside the abdominal cavity is reflected into the abdomen. It is usually accompanied by symptoms of the disease against which the described syndrome develops - fever (if it is an infection), pain in the heart or in the joints (with coronary heart disease or rheumatism), etc.
A psychogenic pain are not associated with diseases of internal organs. They are neurotic and are most often caused by stress, shock and depressive state sick.

I would like to emphasize that any pain in the abdomen should be a reason to consult a doctor, because abdominal syndrome, as you have seen, can be a sign of a condition that requires urgent surgery and threatens the patient’s life.

Features of the manifestation of chronic abdominal pain

Abdominal pain syndrome can manifest itself in short-lived and rapidly developing attacks, or it can also be protracted and chronic.

In the latter case, the pain, as a rule, increases gradually and recurs over several weeks or even months. And it should be said that the chronic form of the syndrome is mainly formed depending on psychological factors, and not on the degree of damaging effects. That is this pathology to some extent ceases to reflect the degree of the underlying disease and begins to develop according to its own laws.

Researchers believe that chronic abdominal syndrome is often triggered by a state of latent depression. Such patients, as a rule, complain of a combination of different localizations of pain - for example, they may simultaneously have pain in their head, back, stomach, etc. Therefore, they often characterize their condition as follows: “My whole body hurts.”

True, not all chronic abdominal pain is caused by mental disorders– they can also appear against the background of cancer, joint diseases, coronary disease hearts. But in this case the syndrome has a clear limited localization.

Manifestations of abdominal syndrome that require urgent hospitalization

As mentioned earlier, acute abdominal syndrome in some cases may be a sign of serious dysfunction of some organs in the abdominal cavity or outside it. Therefore, in order not to expose yourself to possible danger when abdominal pain occurs, you should know in which cases it requires urgent medical attention.

if, along with pain, severe weakness, dizziness and a state of apathy appear;
multiple subcutaneous hematomas appear on the body;
the patient suffers from repeated vomiting;
abdominal muscles are tense;
along with pain, tachycardia occurs and blood pressure decreases;
the patient is worried about a fever, the origin of which is unclear;
the volume of the abdomen increases greatly, accompanied by severe pain;
gases do not escape, and there are no peristaltic sounds;
women appear copious discharge or bleeding.

Each of these signs (and even more so their combination) requires mandatory consultation with a specialist, as it may be a manifestation of a life-threatening condition.

Abdominal pain syndrome in children

Children are a special risk group for the development of abdominal syndrome. This is due to the child’s body’s ability to overreact to any damaging factors.

Thus, at an early age, the named syndrome may be provoked by excessive gas formation, causing intestinal colic in the baby. And occasionally, the cause may be intussusception (a type of obstruction) of the intestine, requiring immediate hospitalization, or congenital anomalies abdominal organs.

Abdominal syndrome in school-age children most often turns out to be a sign of chronic gastroduodenitis or dysfunction of the pancreas. Often the syndrome develops against the background of acute or chronic pathology kidneys or bladder. In teenage girls, it can manifest itself during the formation of the menstrual cycle. By the way, in this case, the appearance of pain may be a sign of the presence of ovarian cysts.

Difficulties in diagnosing abdominal syndrome in children

Abdominal syndrome in children causes certain difficulties in diagnosing the pathology that caused the pain. This is due to the fact that the child is most often unable to accurately characterize his sensations, their localization, strength and presence of irradiation.

By the way, pediatricians say that children quite often describe any ailment or feeling of discomfort as abdominal pain. Doctors encounter this description even in cases where the child clearly experiences dizziness, pain in the ears, head, or nausea.

Methods of dealing with abdominal syndrome in children, as well as in adults, directly depend on the underlying disease that caused its occurrence, so experts strongly recommend that parents not take independent decisions and do not try to relieve the baby’s abdominal pain without the help of a specialist using antispasmodics or painkillers. The fact is that such actions can blur the picture of what is happening with the child, make an already difficult diagnosis even more difficult, and thereby cause serious consequences.

This means that if your child complains of abdominal pain and other signs of abdominal syndrome, you should immediately consult a doctor. In this case, it is better to be safe!

Manifestation of the syndrome in ARVI

Pediatricians often observe ARVI with abdominal syndrome. In children, this is also due to the peculiarity of the body’s reaction to damaging factors.

In such cases, to usual symptoms viral infection - redness of the throat, runny nose, cough, weakness and fever - a small patient may experience vomiting and abdominal pain. But these manifestations may turn out to be both a feature of the child’s body’s response to infection and, for example, a sign of a chronic pathology of the abdominal organs that has worsened against the background of ARVI.

Therefore, the diagnosis of “ARVI with abdominal syndrome” in medical circles is considered inaccurate and streamlined. It does not give a specific explanation of what is happening in the patient’s body at the moment, and a patient with manifestations of signs of the mentioned syndrome requires mandatory additional examination to exclude surgical reasons occurrence of abdominal pain.

How is abdominal syndrome treated?

Due to the fact that the described condition is not a separate disease, but only a complex of symptoms, abdominal syndrome should be dealt with by eliminating, first of all, the cause that caused the disease. A significant role in this is also played by the elimination of motor disorders in the gastrointestinal tract and the normalization of the patient’s perception of pain.

To eliminate the discomfort that appears due to problems with the gastrointestinal tract, myotropic antispasmodics are usually prescribed. The most popular among them is the drug "Drotaverine", which has a high selective effect and does not have negative influence on the nervous and cardiovascular system. This remedy not only has an antispasmodic effect, but also helps reduce blood viscosity, which makes it possible to use it not only for biliary dyskinesia, gastric or duodenal ulcers, but also for ischemic intestinal disease.

No less effective are drugs related to muscarinic receptor blockers (they create conditions for muscle relaxation and relief of spasms) or selective and non-selective anticholinergic blockers (Gastrocepin, Platifillin, Metacin, etc.).

What is abdominal ischemic syndrome

In medicine, it is customary to distinguish abdominal pain syndrome from the various abdominal pain described above. chronic ischemia. It is a long-term insufficiency of blood supply to various parts of the abdominal aorta as a result of:

severe cardiovascular disorders;
arteritis;
vasculitis;
abnormal development and compression of blood vessels;
as well as the appearance of cicatricial stenoses after injuries and operations.

This condition is fraught with the death (necrotization) of areas of blood vessels or organs that do not receive sufficient oxygen and do not remove decay products.

Interestingly, abdominal ischemic syndrome is most often found in men after 45 years of age. And it manifests itself, as a rule, as a triad of symptoms - pressing and aching, often paroxysmal pain in the abdomen, intestinal dysfunction, as well as a progressive decrease in body weight.

How to deal with abdominal ischemic syndrome

The pain usually appears about half an hour to an hour after eating and can last up to four hours. Sometimes it radiates to the back or to left side chest and is accompanied by flatulence, belching, nausea, vomiting, regardless of the quality of food taken.

It can be provoked not only by food, but also by physical stress or fast walking, and the pain is relieved at rest on its own, although sometimes this requires additional nitroglycerin or (in case of increased intensity) analgesics.

When diagnosed with “abdominal ischemic syndrome,” treatment, as in other cases, is aimed at the underlying disease. The patient is prescribed antispasmodics, drugs that improve blood circulation, anticoagulants, and in the case of intestinal dysbiosis, drugs that improve its microflora.

Patients are usually recommended to eat fractional meals in small portions with the exception of coarse and gas-forming products. And in severe cases of the disease, they may be indicated for surgical intervention to restore blood circulation in the abdominal branches of the aorta.

Compartment syndrome

If the patient’s intra-abdominal pressure increases as a result of complications caused by injury or surgery, then this condition is diagnosed as abdominal compartment syndrome. It is quite dangerous and is also accompanied by abdominal pain of varying strength and localization, which also depends on the altitude. pain threshold in the patient, and on his general condition.

By the way, there are no specific symptoms indicating intra-abdominal hypertension, therefore, to make this diagnosis, a physical method of examining the abdomen or studying the general clinical picture diseases. The most accurate way to determine hypertension in this case, according to experts, is to measure the pressure in the bladder, which can serve as a starting point for prescribing urgent, adequate treatment.

As already mentioned, compartment syndrome is dangerous condition. Without special treatment, it can lead not only to serious dysfunction of the abdominal organs, but even to death. As a rule, the most effective way to combat the mentioned abdominal syndrome is surgical intervention - the so-called decompression, as a result of which the level of intra-abdominal pressure is reduced and blood circulation in the abdominal area is restored.

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Differential diagnosis of abdominal pain syndrome. Abdominal syndrome - what is it?

When abdominal pain occurs, many rush to take a No-shpa or Phthalazole tablet, believing that they have a problem with the digestive organs. However, the stomach can hurt due to a dozen reasons that have absolutely nothing to do with the stomach or intestines. This phenomenon even has a medical term - abdominal syndrome. What it is? The name comes from the Latin “abdomen”, which translates as “belly”. That is, everything related to this area human body, is abdominal. For example, the stomach, intestines, bladder, spleen, kidneys are abdominal organs, and gastritis, pancreatitis, cholecystitis, colitis and other gastrointestinal problems are abdominal diseases. By analogy, abdominal syndrome is all the troubles in the abdomen (heaviness, pain, tingling, spasms and other bad sensations). With such patient complaints, the doctor’s task is to correctly differentiate the symptoms so as not to make a mistake with the diagnosis. Let's figure out how this is done in practice and what the characteristics of pain are for each disease.

Human abdomen

To make it easier to understand the question: “Abdominal syndrome - what is it?” and to understand where it comes from, you need to clearly understand how our stomach works, what organs it contains, how they interact with each other. In anatomical pictures you can see a schematic tube of the esophagus, a baggy stomach, an intestine wriggling like a snake, the liver on the right under the ribs, the spleen on the left, and at the very bottom the bladder with ureters extending from the kidneys. That, it seems, is all. In reality, our abdominal cavity has more complex structure. Conventionally, it is divided into three segments. The border of the upper one is - on the one hand - a dome-shaped muscle called the diaphragm. Above it is the chest cavity with the lungs. On the other hand, the upper segment is separated from the middle by the so-called mesentery of the colon. This is a two-layer fold, with the help of which all organs of the gastrointestinal tract are attached to the posterior plane of the abdomen. In the upper segment there are three sections - hepatic, pancreas and omental. The middle segment extends from the mesentery to the beginning of the pelvis. It is in this part of the abdomen that the umbilical zone is located. And finally, the lower segment is the pelvic area, in which the organs of the genitourinary and reproductive systems find their place. Any disturbances (inflammation, infection, mechanical and chemical influences, pathologies of formation and development) in the activity of each organ located in the above three segments cause abdominal syndrome. In addition, the peritoneum contains blood vessels and lymphatic vessels and nerve nodes. Among them, the most famous are the aorta and solar plexus. The slightest problem with them also provokes abdominal pain.

To summarize: abdominal syndrome can be caused by any currently known disease of the gastrointestinal tract and genitourinary system, problems with blood vessels and nerve plexuses of the peritoneum, chemical exposure (poisoning, drugs), mechanical compression (squeezing) neighboring organs everything that is located in the peritoneum.

The pain is acute

Differential diagnosis of abdominal pain syndrome, as a rule, begins with determining the location and nature of the pain. The most life-threatening and difficult for a person to endure is, of course, acute pain. It occurs suddenly, sharply, often without any visible reasons that provoked it, and manifests itself in attacks lasting from several minutes to an hour.

Acute pain may be accompanied by vomiting, diarrhea, fever, chills, cold sweat, and loss of consciousness. Most often they have a precise localization (right, left, bottom, top), which helps to establish a preliminary diagnosis.

Diseases that cause this abdominal syndrome are:

1. Inflammatory processes in the peritoneum - acute and recurrent appendicitis, Meckel's diverticulitis, peritonitis, acute cholecystitis or pancreatitis.

2. Intestinal obstruction or strangulated hernia.

3. Perforation (perforation, hole) of the peritoneal organs, which occurs with a stomach and/or duodenal ulcer and diverticulum. This also includes ruptures of the liver, aorta, spleen, ovary, and tumors.

In cases with perforation, as well as appendicitis and peritonitis, the patient’s life depends 100% on correct setting diagnosis and emergency surgery.

Additional research:

blood test (makes it possible to assess the activity of the inflammatory process and determine the blood group);
X-ray (shows the presence or absence of perforation, obstruction, hernia);
if there is a suspicion of bleeding in the gastrointestinal tract, an esophagogastroduodenoscopy is performed.

Chronic pain

They grow gradually and last for many months. The sensations seem to be dull, pulling, aching, often “spread” over the entire periphery of the peritoneum, without specific localization. Chronic pain may subside and return again, for example, after eating something. In almost all cases, such abdominal syndrome indicates chronic diseases of the abdominal organs. It can be:

1) gastritis (pain in the upper segment, nausea, heaviness in the stomach, belching, heartburn, problems with bowel movements);

2) stomach and/or duodenal ulcer on early stages(pain in the pit of the stomach on an empty stomach, at night or shortly after eating, heartburn, sour belching, bloating, flatulence, nausea);

3) urolithiasis (pain in the side or lower abdomen, blood and/or sand in the urine, pain when urinating, nausea, vomiting);

4) chronic cholecystitis(pain in the upper segment on the right, general weakness, bitterness in the mouth, low temperature, persistent nausea, vomiting - sometimes with bile, belching);

5) chronic cholangitis (pain in the liver area, fatigue, yellowness of the skin, low temperature, with acute form pain can radiate to the heart and under the shoulder blade);

6) oncology of the gastrointestinal tract in the initial stage.

Recurrent pain in children

Recurrent pain is pain that recurs over a period of time. They can occur in children of any age and in adults.

In newborns, intestinal colic is a common cause of abdominal pain (can be identified by sharp, high-pitched crying, restless behavior, bloating, refusal to eat, arching of the back, chaotic rapid movements of arms and legs, regurgitation). An important sign Intestinal colic is that when they are eliminated, the baby becomes calm, smiles, and eats well. Heat, tummy massage, and dill water. As the baby grows up, all these troubles go away on their own.

A much more serious problem is abdominal syndrome in somatic pathology in children. "Soma" means "body" in Greek. That is, the concept of “somatic pathology” means any disease of the body organs and any congenital or acquired defect. In newborns the following are most often observed:

1) infectious diseases Gastrointestinal tract (temperature up to critical levels, refusal to eat, lethargy, diarrhea, regurgitation, vomiting, crying, in some cases, change in skin color);

2) pathologies of the gastrointestinal tract (hernia, cyst and others).

Making a diagnosis in this case is complicated by the fact that the baby is not able to show where it hurts and explain his feelings. Differential diagnosis of abdominal pain syndrome in newborns is carried out using additional examinations, such as:

coprogram;
blood analysis;
esophagogastroduodenoscopy;
barium x-ray of the abdominal cavity;
daily pH-metry.

Recurrent pain in adults

In older children (mostly school age) and adults, there are so many causes of recurring abdominal pain that they have been divided into five categories:

What infectious and inflammatory pain is is more or less clear. What do functional mean? If they are indicated in the diagnosis, how then should we understand the term “abdominal syndrome in children”? What it is? The concept of functional pain can be explained as follows: patients are bothered by discomfort in the abdomen for no apparent reason and without diseases of the peritoneal organs. Some adults even believe that the child is lying about his pain, since no violations are found in him. However, such a phenomenon exists in medicine, and it is usually observed in children over 8 years of age. Functional pain can be caused by:

1) abdominal migraine (abdominal pain turns into headache, accompanied by vomiting, nausea, refusal to eat);

2) functional dyspepsia (in a completely healthy child, pain appears in the upper segment of the abdomen and disappears after defecation);

3) intestinal irritation.

Another controversial diagnosis is “ARVI with abdominal syndrome” in children. Treatment in this case has some specificity, since children have symptoms of both colds and intestinal infection. Doctors often make this diagnosis for children who have the slightest signs ARVI (for example, runny nose), but confirmation of diseases of the gastrointestinal tract is not detected. Frequency similar cases, as well as the epidemic nature of the disease, deserve more detailed coverage.

ARI with abdominal syndrome

This pathology is more often observed in preschool children and junior schoolchildren. It occurs extremely rarely in adults. In medicine, acute respiratory infections and acute respiratory viral infections are classified as a single type of illness, since acute respiratory infections ( respiratory diseases) are most often caused by viruses, and they automatically become classified as RVI. It’s easiest to “catch them” in children’s groups – school, kindergarten, nursery. Besides the well-known respiratory flu, the so-called “ stomach flu", or rotavirus. It is also diagnosed as ARVI with abdominal syndrome. In children, symptoms of this disease appear 1-5 days after infection. The clinical picture is as follows:

As can be seen from the list, there are symptoms of both a cold and an intestinal infection. In rare cases, a child may actually have a common cold plus a gastrointestinal disease, which doctors must clearly distinguish between. Diagnostics rotavirus infection extremely complex. It includes linked immunosorbent assay, electron microscopy, diffuse precipitation, carrying out many reactions. Pediatricians often make a diagnosis without such complex tests, only based on the clinical manifestations of the disease and based on anamnesis. With rotavirus infection, although cold symptoms are present, it is not the ENT organs that are infected, but the gastrointestinal tract, mainly the colon. The source of infection is a sick person. Rotaviruses enter the body of a new host with food, through dirty hands, and household items (for example, toys) used by the patient.

Treatment of ARVI with abdominal syndrome should be based on the diagnosis. So, if abdominal pain in a child is caused by pathological waste products of respiratory viruses, the underlying disease is treated, plus rehydration of the body by taking sorbents. If rotavirus infection is confirmed, there is no point in prescribing antibiotics to the child, since they have no effect on the pathogen. Treatment consists of taking activated carbon, sorbents, diet, drinking plenty of fluids. If a child has diarrhea, probiotics are prescribed. Prevention of this disease is vaccination.

Paroxysmal pain without bowel disease

To make it easier to determine what causes abdominal syndrome, pain is divided into categories according to the location in the abdominal area where it is felt most strongly.

Paroxysmal pain without symptoms of dyspepsia occurs in the middle segment (mesogastrium) and lower segment (hypogastrium). Possible reasons:

infection with worms;
Payr's syndrome;
pyelonephritis;
hydronephrosis;
problems with the genitals;
intestinal obstruction (incomplete);
stenosis (compression) of the celiac trunk;

If the patient has just such an abdominal syndrome, treatment is prescribed based on additional examinations:

extended blood test;
sowing stool for worm eggs and intestinal infections;
Analysis of urine;
Ultrasound of the gastrointestinal tract;
irrigography (irrigoscopy with barium beam method);
Dopplerography of abdominal vessels.

Abdominal pain with bowel dysfunction

All five categories of recurrent pain can be observed in the lower and middle segments of the peritoneum with intestinal problems. There are many reasons why this abdominal syndrome occurs. Here are just a few of them:

helminthiasis;
allergies to any products;
nonspecific ulcerative colitis (additionally, diarrhea is observed, and the stool may contain pus or blood, flatulence, loss of appetite, general weakness, dizziness, weight loss);
celiac disease (more often observed in young children when they begin to feed them with infant formula containing cereals);
infectious diseases (salmonellosis, campylobacteriosis);
pathologies in the colon, for example, dolichosigma ( sigmoid colon elongated), while prolonged constipation is added to the pain;
disaccharidase deficiency;
hemorrhagic vasculitis.

The latter disease appears when the blood vessels in the intestines, they thrombose. The reasons are disturbances in blood circulation processes and a shift in hemostasis. This condition is also known as hemorrhagic abdominal syndrome. It is differentiated in three degrees of activity:

I (mild) – symptoms are mild, determined by ESR levels in the blood.

II (moderate) – mild pain in the peritoneum is observed, the temperature rises, weakness and headache appear.

III (severe) - high temperature, severe headaches and abdominal pain, weakness, nausea, vomiting with blood, urine and feces with blood, bleeding in the stomach and intestines, perforation may occur.

If pain occurs in the middle and lower parts of the peritoneum with suspicion of any problems with the intestines, diagnosis includes:

extended blood test (biochemical and general);
coprogram;
fibrocolonoscopy;
irrigography;
stool culture;
blood test for antibodies;
hydrogen test;
Endoscopy and tissue biopsy of the small intestine;
immunological tests;
sugar curve.

Pain in the upper segment of the peritoneum (epigastric)

Most often, abdominal syndrome in the upper segment of the peritoneum is a consequence of food intake and can manifest itself in two forms:

dyspepsia, that is, with disruption of the stomach (“hunger pains” that go away after eating);
dyskinetic (bursting pain, feeling of overeating, regardless of the amount of food taken, belching, vomiting, nausea).

Reasons similar conditions may become gastroduodenitis, hypersecretion in the stomach of hydrochloric acid, infections, worms, diseases of the pancreas and/or biliary tract, impaired gastroduodenal motility. In addition, pain in the epigastrium can be caused by Dunbar's syndrome (pathology of the celiac trunk of the aorta when it is compressed by the diaphragm). This disease can be congenital, hereditary (often) or acquired when a person develops neurofibrous tissue.

The celiac trunk (a large short branch of the aorta of the peritoneum) during compression turns out to be pressed against the aorta, strongly narrowed at its mouth. This causes abdominal ischemic syndrome, which is diagnosed using contrast X-rays (angiography). The celiac trunk, together with other blood vessels of the abdominal cavity, supplies blood to all organs of the gastrointestinal tract. When compressed, the delivery of blood, and therefore the supply of organs with necessary substances, does not occur in full, which leads to their oxygen starvation(hypoxia) and ischemia. The symptoms of this disease are similar to those observed with gastritis, duodenitis, and stomach ulcers.

If the intestines experience a lack of blood supply, it develops ischemic colitis, enteritis. If insufficient blood flows to the liver, hepatitis develops, and the pancreas responds to disruptions in the blood supply with pancreatitis.

In order not to make a mistake with the diagnosis, it is necessary to carry out additional examinations patients with suspected abdominal ischemic syndrome. Endovascular diagnostics is an advanced method in which blood vessels are examined by inserting a catheter with X-ray properties into them. That is, the method will allow you to see problems in the vessels without surgical intervention. Endovascular diagnostics is used for any vascular diseases of the abdominal cavity. If there are indications, endovascular operations are also performed. Abdominal ischemic syndrome can be suspected based on the following patient complaints:

constant abdominal pain, especially after eating, when doing any physical work or emotional stress;
sensations of fullness and heaviness in the upper segment of the peritoneum;
belching;
heartburn;
feeling of bitterness in the mouth;
diarrhea or, conversely, constipation;
frequent headaches;
dyspnea;
throbbing in the abdomen;
weight loss;
general fatigue and weakness.

Only an external examination of the patient, as well as standard diagnostic methods (blood tests, urine tests, ultrasound) are not decisive in detecting this disease.

Vertebral abdominal syndrome

This type of pathology is one of the most difficult to detect. It lies in the fact that patients have obvious signs problems with the gastrointestinal tract (abdominal pain, vomiting, belching, heartburn, diarrhea or constipation), but they are caused by diseases of the spine or other parts musculoskeletal system. Often doctors do not immediately correctly determine the cause, so they carry out treatment that does not bring results. So, according to statistics, about 40% of patients with osteochondrosis thoracic, are being treated for intestinal and stomach diseases that do not exist. The picture with spinal diseases is even sadder. The pain in such cases is most often aching, dull, absolutely unrelated to food intake, and if patients have constipation or diarrhea, they are not treated classical methods. The following diseases can cause vertebral abdominal syndrome:

spondylosis;
scoliosis;
spinal tuberculosis;
syndromes associated with tumor changes in the spinal column;
visceral syndromes (Gutzeit).

The saddest thing is that patients who complain of abdominal pain and do not have gastrointestinal pathologies are often perceived as malingerers. To find out the cause of unexplained abdominal pain, you need to use additional methods diagnostics, such as spondylography, X-ray, MRI, X-ray tomography, echospondylography and others.

Abdominal syndrome (AS) is a complex of symptoms of a number of diseases of the digestive system. Acute abdominal pain is the main clinical manifestation of the disease. It is caused by involuntary muscle contractions digestive tract, overstretching of the biliary ducts, bloating or inflammation of the peritoneum.

Abdominal syndrome refers to an urgent pathology called “acute abdomen”. It is caused by diseases and injuries of the gastrointestinal tract. The etiological factors of abdominal pain are diverse, which is due to the presence in the abdominal cavity of many organs, the pain receptors of which react to different stimuli. Patients experience severe abdominal pain, which can be acute, dull, pulling, cramping or girdling. The causes of AS, which manifests itself sharply and intense pain in the abdomen, diseases of the nervous system, heart and blood vessels, and bronchopulmonary tree can also occur.

The disease is observed mainly in children. They are most often diagnosed with ARVI with AS. Abdominal pain is usually accompanied by catarrhal symptoms, intoxication manifestations, leukocytosis and other indicators of viral infection in the blood. If these signs occur, you should immediately contact a specialist, whose task is to establish the correct diagnosis and alleviate the patient’s condition.

Etiology

The causes of abdominal pain syndrome are inflammatory pathologies internal organs, which are conventionally divided into two large groups - intra-abdominal and extra-abdominal.

The first group includes pathologies of organs located in the abdominal cavity:

Diseases of the hepatobiliary zone - cholecystitis, cholelithiasis, hepatitis;
Inflammation of the spleen and lymph nodes - lymphadenitis, splenic infarction;
Pathologies of the stomach and intestines - diverticulitis, colitis, appendicitis, gastric ulcer, gastroenteritis, tumors, IBS, Crohn's disease;
Diseases of the pancreas - pancreatitis;
Inflammation of the peritoneum - peritonitis, as well as thrombosis of mesenteric vessels.

With inflammation, obstruction and ischemia of internal organs, pain occurs and the normal operation the whole body. The pain is localized in different areas abdominal cavity.

Extra-abdominal diseases of internal organs manifested by abdominal pain, the source of which is outside the abdominal cavity:

Diseases bronchopulmonary system- pneumonia, pleurisy;
Pathology of the cardiovascular system - ischemic heart disease, vasculitis, periarteritis;
Diseases of the esophagus - diverticulosis;
Diseases of the genital organs - endometriosis;
Inflammation of the kidneys, bladder and urinary ducts - pyelonephritis, paranephritis;
Pathology of the nervous system - meningitis, brain injuries and tumors, neuralgia;
Infectious diseases - influenza, measles, scarlet fever, syphilitic infection;
Metabolic disorder - diabetes mellitus;
Systemic diseases - rheumatism;
Injuries and ailments of the spine.

These diseases are manifested by pseudoabdominal syndrome. Radiating pain in the abdomen occurs reflexively with heart disease, pleural cavity, urinary system, central nervous system. At the same time, dyspeptic symptoms are accompanied by clinical manifestations main pathological process- fever with infectious processes, cardialgia due to coronary heart disease, joint pain for rheumatism.

Factors that provoke the appearance of unpleasant symptoms:

Passive lifestyle;
Stress;
Poor nutrition;
Taking antibiotics or NSAIDs;
Intestinal diseases and more.

Children constitute a special category of the population that is most at risk of suffering from AS. This is related to the ability child's body react in a special way to any damaging factor. Abdominal colic occurs in almost every newborn baby. Night pain often requires urgent hospitalization of the child. They cause acute appendicitis or intestinal obstruction. Recently, ARVI with abdominal syndrome has become very common. In such cases, the disease is treated conservatively, after visiting a doctor and diagnosing correct diagnosis. In patients, hyperemia and sore throat, runny nose, cough and fever are combined with nausea, vomiting and abdominal pain.

Symptoms

Pain is the only clinically significant sign of acute abdominal syndrome. To diagnose a pathology that manifests itself with these signs, it is necessary to know certain distinctive characteristics pain due to certain diseases.

For acute coronary insufficiency, renal or biliary colic occurs in a protruding, very intense and burning pain in a stomach. The pain is pronounced, strong, its intensity directly depends on the extent of the lesion. It does not go away on its own, has a wave-like course and subsides after the injection of painkillers. After some time, the pain resumes.
Intestinal obstruction, acute inflammation pancreas and thrombosis of mesenteric vessels are characterized by the rapid development of the most severe pain, which remains at its peak for a long time.
With diverticulitis, acute cholecystitis and appendicitis, the attack develops slowly and lasts for hours.

The pain that occurs with abdominal syndrome is divided by origin into 2 large groups - functional and organic. The first is caused by spasm of the smooth muscles of the internal organs, the second by inflammation of the mucous membrane, strangulated hernia, obstruction, perforation of hollow organs or rupture of parenchymal organs.

According to the severity and nature, abdominal pain is divided into acute, short-lived - rapidly increasing and chronic - gradually progressing.

In addition to pain of varying intensity and severity, AS is manifested by vomiting, dry tongue, muscle tension in the anterior abdominal wall, leukocytosis, dizziness, flatulence, hyperthermia, chills, change in color of stool, and intestinal paresis.

Emergency hospitalization is required for patients who experience the following symptoms of “acute abdomen”:

Marked asthenia of the body,
Bleeding or subcutaneous hematomas,
Uncontrollable vomiting
Abdominal bloating and lack of peristalsis,
Tension of the muscles of the anterior abdominal wall,
Increased heart rate and drop in blood pressure,
High body temperature,
Pain during defecation
Intensive increase in abdominal volume,
Rapid increase in pain
Fainting during bowel movements
Uterine bleeding.

Abdominal syndrome is usually diagnosed in children and young adults. They complain of abdominal pain, which gets worse when physical activity. When the pain is unbearable, they lose their appetite, vomit, and lose weight. Pain is often preceded by discomfort and heaviness in the epigastrium, heartburn, vomiting, and diarrhea. Any pain in the abdomen is a reason to see a doctor. Acute abdominal pain usually requires urgent surgery and often threatens the patient's life.

In newborns, abdominal pain is usually associated with intestinal colic. This is the most trivial reason, which does not pose a danger to the life of the child. More serious reasons include: lactose deficiency, allergies, dysbacteriosis, gastric reflux. Children become restless and capricious, often cry and refuse to eat. They constantly move their legs and tuck them towards their chest. A rash appears on the skin, stool becomes loose and profuse. Weight loss occurs.

Experts separately consider ischemic abdominal syndrome. It develops when the blood supply to the digestive organs is disrupted due to damage to the abdominal cavity by internal narrowing or external pressure. The pain gradually increases and reaches extreme expressiveness. Necrotic processes in the gastrointestinal tract are caused by a lack of oxygen and the accumulation of decay products. Pressing, aching, paroxysmal pain in the abdomen is combined with intestinal dysfunction and progressive weight loss.

Compartment syndrome- complication traumatic injury abdominal cavity or postoperative condition associated with increased intra-abdominal pressure. This dangerous illness manifested by abdominal pain of varying strength and localization. To determine intra-abdominal hypertension, it is necessary to measure the pressure in the bladder. Treatment of the syndrome is surgical. Patients undergo decompression, which reduces intra-abdominal pressure. Otherwise, irreversible changes in the functioning of internal organs can lead to death.

Diagnostic measures

Diagnosis of AS consists of determining the nature of the pain, its location and intensity. In addition to the patient's complaints, medical history, examination and physical examination, the results of additional techniques are required to make a diagnosis.

Laboratory research:

Hemogram - leukocytosis and other signs of inflammation,
Urinalysis can detect pyelonephritis, inflammation of the urogenital tract, urolithiasis,
Liver tests for lipase and amylase - if pancreatitis, cholecystitis, cirrhosis is suspected.

Instrumental methods:

Ultrasound examination of internal organs,
Tomographic study,
X-ray examination,
Fibroesophagogastroduodenoscopy,
Video colonoscopy,
Sigmoidoscopy,
Capsule endoscopy.

In children, the diagnosis of abdominal syndrome is complicated by the fact that they cannot specifically describe their sensations, the nature and location of pain, its irradiation and accompanying symptoms. With any ailment, children often indicate abdominal pain. Diagnosis of abdominal syndrome in adults and children consists of identifying the disease that has become its root cause. Doctors recommend that their patients not take antispasmodics and painkillers if abdominal pain occurs. These drugs do not treat the disease, but only eliminate the symptom, blurring the overall picture of the pathology and making diagnosis even more difficult, which can lead to serious consequences.

Treatment process

Treatment of abdominal pain syndrome is carried out in a hospital setting. It depends on the reasons that provoked the discomfort in the abdomen and is aimed at eliminating the pain syndrome. If the cause of the pathology is not established, restorative and symptomatic therapy is carried out. An integrated therapeutic approach allows you to get rid of pathology caused by non-dangerous causes, even at home. In more serious cases, specialist advice is required.

Patients are prescribed:

Diet therapy consists of eliminating coarse and gas-forming foods, fried, spicy, fatty foods, alcoholic drinks, strong tea and coffee. Patients are prescribed gentle nutrition in small portions every 3 hours. Preference should be given to lean soups, dietary meat and fish, stewed vegetables, and some cereal products. Compliance with the drinking regime is a mandatory recommendation of the attending physician.

Facilities traditional medicine normalize the functioning of the digestive and nervous systems. Decoctions of chamomile and mint have an antispasmodic effect on the intestines, dill water eliminates flatulence, and an infusion of valerian root helps to calm down.

A healthy lifestyle helps reduce the risk of developing abdominal syndrome. Short-term pain in the abdomen, lasting one or two minutes, do not require special medical attention.

When symptoms of an “acute abdomen” appear, patients are urgently hospitalized by ambulance in the surgical department of the hospital. Surgery is also performed to restore blood circulation in the abdominal branches of the aorta.

Prevention and prognosis

Special preventive measures the disease has not yet been developed. Proper nutrition, maintaining a healthy lifestyle, physical education are standard methods that allow each person to feel satisfactory and get sick less. To prevent the occurrence of abdominal pain, it is necessary to promptly treat the underlying disease that caused AS.

The prognosis of the pathology is relatively favorable. Timely diagnosis And adequate treatment allow you to quickly get rid of abdominal pain and other symptoms.

Abdominal pain is a dangerous manifestation of diseases of the abdominal organs, in which the destruction of cells and tissues is caused by many factors. Timely diagnosis and competent treatment AS can eliminate abdominal pain and normalize the functioning of affected organs.

Video: acute abdomen in the “Concilium” program

Sometimes on the 1st - 2nd day of illness an abdominal syndrome occurs, manifested by abdominal pain, vomiting and frequent bowel movements in the absence of symptoms of peritoneal irritation. Such patients are sometimes sent to the hospital with a diagnosis of appendicitis. Abdominal syndrome lasts 1-2 days and is eliminated in many patients even before the temperature drops.

The cause of its occurrence is, apparently, toxic damage to the autonomic nervous system. The patient's skin is moist due to increased sweating. Occasionally, quickly fading skin rashes of various types are observed: scarlet fever-like, macular, urticaria-like.

Great care should be taken when assessing the nature of these rashes, as they may be signs of some other infection (scarlet fever, measles, etc.). Some patients develop herpes.

The pharynx is often hyperemic. Granularity of the mucous membrane of the soft palate, which, according to N.I. Morozkin, is very characteristic of influenza in adults, is not always observed in children: it also occurs in other infections.

On the blood side, at the very beginning of the disease, short-term leukocytosis is observed, and then moderate leukopenia, lymphocytosis, monocytosis, eosinopenia or aenosinophilia and toxic granularity of neutrophils; ESR is within normal limits or slightly increased.

The temperature, giving incorrect remissions, stays on high level, and then decreases, and a significant improvement in the patient’s condition occurs. Some consider biphasic fever to be typical for influenza, i.e., the appearance after a short-term remission (from 1 to 3 days) of a new increase in temperature in the absence of any complications.

However, such repeated increases in temperature are observed in a smaller number of patients. The total duration of the disease in the absence of complications ranges from 3 to 7 - 8 days. After the temperature drops, the patient's strength is restored slowly. Children who have had the flu are still long time feel weak, suffer from insomnia, and are irritable.

Their body shows reduced resistance to the effects external environment. Based on the main clinical syndromes, reflecting the clinical and pathogenetic essence of the disease, we distinguish three main forms of influenza: toxic (and, as an option, subtoxic), catarrhal and toxic-catarrhal.

If there are additional syndromes, the characteristics of each of these forms can be supplemented accordingly (with encephalopathy syndrome, with croup syndrome, with asthmatic, hemorrhagic syndromes and etc.). Based on severity, influenza can be divided into mild, moderate and severe. A type of mild flu is the erased form, which is carried by patients on their feet. It is of great epidemiological significance.

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S.D. Nosov

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