소아청소년 만성 복통증의 진단적 접근의 실제 (Practical Diagnostic Approaches to Chronic Abdominal Pain in Children and Adolescents)

서지정보

· 발행기관 : 대한의사협회
· 수록지 정보 : 대한의사협회지 / 52권 / 3호 / 271 ~ 284페이지
· 저자명 : 황진복, 정성훈

초록

Chronic abdominal pain (CAP) in children and adolescents remains one of the pathogenetically
ambiguous disorders and a great trouble to their caretakers as well as patients.
Although the symptom does not usually lead to a crucial problem, the parents may be terribly
worried, the child may be in distress, and the practitioner may be concerned about ordering tests
to confirm a serious occult disease. Systemized diagnostic approaches are needed to overcome
this unique difficulty. The presence of red flag symptoms or signs is a general indication to
pursue diagnostic testing for organic etiologies of CAP on the basis of specific symptoms in an
individual case. Functional abdominal pain can be normally diagnosed when there are no red
flag symptoms or signs. According to the Rome III criteria for pediatric functional gastrointestinal
disorders, functional disorders of CAP can be classified into functional dyspepsia, irritable bowel
syndrome, abdominal migraine, and chronic functional abdominal pain syndrome. Cyclic
vomiting syndrome and pathologic aerophagia are also major functional causes of CAP. Modern
concepts of the pathogenesis of functional abdominal pain include brain-gut interaction, visceral
hypersensitivity, autonomic dysfunction, and psychosocial factors. In addition, psychiatric
disorders, presented with red flag symptoms or signs, may induce the CAP in children and
adolescents. We introduce practical and systemized diagnostic approaches by illustrating clinical
cases of CAP in children and adolescents.

영어초록

Chronic abdominal pain (CAP) in children and adolescents remains one of the pathogenetically
ambiguous disorders and a great trouble to their caretakers as well as patients.
Although the symptom does not usually lead to a crucial problem, the parents may be terribly
worried, the child may be in distress, and the practitioner may be concerned about ordering tests
to confirm a serious occult disease. Systemized diagnostic approaches are needed to overcome
this unique difficulty. The presence of red flag symptoms or signs is a general indication to
pursue diagnostic testing for organic etiologies of CAP on the basis of specific symptoms in an
individual case. Functional abdominal pain can be normally diagnosed when there are no red
flag symptoms or signs. According to the Rome III criteria for pediatric functional gastrointestinal
disorders, functional disorders of CAP can be classified into functional dyspepsia, irritable bowel
syndrome, abdominal migraine, and chronic functional abdominal pain syndrome. Cyclic
vomiting syndrome and pathologic aerophagia are also major functional causes of CAP. Modern
concepts of the pathogenesis of functional abdominal pain include brain-gut interaction, visceral
hypersensitivity, autonomic dysfunction, and psychosocial factors. In addition, psychiatric
disorders, presented with red flag symptoms or signs, may induce the CAP in children and
adolescents. We introduce practical and systemized diagnostic approaches by illustrating clinical
cases of CAP in children and adolescents.

참고자료

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