Dysuria is defined as painful urination and can be related to uncomfortable contraction of the muscles of the bladder or when urine comes into contact with the inflamed genitourinary mucosa. The differential diagnoses for a patient presenting with dysuria are…
An abdominal mass or abdominal fullness in a child usually becomes apparent when it enlarges enough to be visualized during bathing or palpable on physical examination. Masses may arise from intraperitoneal, retroperitoneal, or abdominal wall locations and emanate from both…
Constipation is defined symptomatically as the infrequent passage of hard stools, straining while passing a stool, or pain associated with the passage of a hard stool. The range of normal defecation patterns in children is widely variable, though in general,…
Jaundice, the yellow discoloration of skin and sclerae, results when the serum level of bilirubin, a pigmented compound, is elevated. Jaundice is not evident until the total serum bilirubin is at least 2–2.5 mg/dL in children out of the neonatal…
Hepatomegaly can occur as a feature of primary liver disease or as a result of systemic disorders such as congenital anomalies, inborn errors of metabolism, and perinatal or postnatal infections ( Tables 17.1 and 17.2 ). Common symptoms of hepatic dysfunction,…
Gastrointestinal (GI) bleeding in children can range from small amounts of blood in the stool, associated with milk protein allergy or anal fissure, to life-threatening hemorrhage, associated with portal hypertension or peptic ulcer disease. Severe bleeding is a true medical…
Definitions Vomiting/emesis is a protective reflex in response to a variety of stimuli that results in forceful ejection of stomach contents. The emetic reflex is complex and composed of three sequential events. Initially there is a prodromal phase characterized by…
Diarrhea is the passage of unusually loose or watery stools, typically at least three times in a 24-hour period, and should be considered in a child who is passing stools more frequently than usual with a consistency looser than what…
Acute abdominal pain is usually a self-limiting, benign condition that is commonly caused by gastroenteritis, constipation, or a viral illness. The challenge is to identify children who require immediate evaluation for potentially life-threatening conditions. Chronic abdominal pain is also a…
Calories from food provide energy for the body’s maintenance functions of repair, regulation, metabolism, replacement of losses, and daily activity. Children have additional caloric requirements because they are growing. Children under the age of 3 years whose caloric needs are…