Published

2021-12-08

Examen físico abdominal pediátrico

Keywords:

semiología abdominal; pediatría; abdomen; examen físico (es)

Authors

  • Iván Molina Ramírez Universidad Nacional de Colombia
  • Juan Javier Valero Halaby Universidad Nacional de Colombia
  • Paola Andrea Becerra Pedraza Universidad Nacional de Colombia
  • Geraldine Rodríguez López Universidad Nacional de Colombia
  • Claribeth Vásquez Torrejano Universidad Nacional de Colombia
  • Javier Yesid Acuña Rivera Universidad Nacional de Colombia

La patología abdominal representa un importante reto diagnóstico en todos los grupos etarios, especialmente en el pediátrico. La disponibilidad limitada de conocimientos nuevos en la literatura, fenómeno secundado por una continua extrapolación conceptual del adulto al paciente pediátrico, y por el desconocimiento de su particularidades patológicas, anatómicas y semiológicas, entre otras, conducen a apreciaciones erróneas y diagnósticos imprecisos. El presente artículo presenta una revisión del examen físico abdominal pediátrico integral, en el contexto de la patología abdominal quirúrgica y no quirúrgica, destacando sus divergencias respecto al del adulto, la importancia de un adecuado acercamiento al paciente pediátrico y de una anamnesis exhaustiva que favorezca la validez de los hallazgos, además de abordar la relevancia clínica de ciertos signos al examen físico, la utilidad de las técnicas semiológicas en el exploración abdominal y finalmente, algunas consideraciones de masas abdominales y examen de ostomías para un consecuente diagnóstico y tratamiento oportunos.

References

. Kyrklund. K. (2017). Pediatric Surgery: Job or Vocation?. Eur J Pediatr Surg, 27(03), 223-227. https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0037-1603083

Stewart, M. A., Brown, J. B., Boon, H., Galajda, J., Meredith, L., & Sangster, M. (1999). Evidence on patient-doctor communication. Cancer Prev Control, 3(1), 25-30. https://pubmed.ncbi.nlm.nih.gov/10474749/

Chaitoff, A., Sun, B., Windover, A., Bokar, D., Featherall, J., Michael B Rothberg, M. B., & Misra-Hebert, A. D. (2017). Associations Between Physician Empathy, Physician Characteristics, and Standardized Measures of Patient Experience. Acad Med, 92(10), 1464-1471. https://doi.org/10.1097/acm.0000000000001671

Kulik, D., Uleryk, E., & Maguire, J. (2013). Does this child have appendicitis? A systematic review of clinical prediction rules for children with acute abdominal pain. Journal of Clinical Epidemiology, 66(1), 95–104.

Haller, Jr. J. A. (2003). Why pediatric surgery? A personal journey through the first 50 years. Ann Surg. Ann Surg, 237(5), 597-606. https://doi.org/10.1097/01.sla.0000064563.41539.b2

Ministerio de Salud y Protección Social. (s. f.). Ciclo de vida. Ministerio de Salud y Protección Socia-República de Colombia. https://www.minsalud.gov.co/proteccionsocial/Paginas/cicloVida.aspx

Valenzuela, Dra. P. (2018). Semiología pediátrica: características del examen físico en la supervisión de salud del recién nacido hasta la etapa escolar. En Perret, Dra. C., Pérez, C. & Poblete, M. J. (Eds.), Manual de Pediatría (pp. 11-30). Pontificia Universidad de Chile.

Nakayama, D. K. (2016). Examination of the Acute Abdomen in Children. Journal of Surgical Education, 73(3), 548–552. https://doi-org.ezproxy.javeriana.edu.co/10.1016/j.jsurg.2016.01.007

Valman, H. B. (1982). ABC of 1 to 7. The severely ill child. British Medical Journal (Clinical Research Ed.), 284(6326), 1388-1391. https://doi-org.ezproxy.javeriana.edu.co/10.1136/bmj.284.6326.1388

Jolly, J. (1986). Communicating with children. Prof Nurse, 1(10). https://pubmed.ncbi.nlm.nih.gov/3637897/

Katz, A. L., & Webb, S. A. (2016). Informed Consent in Decision-Making in Pediatric Practice. Pediatrics. Pediatrics, 138(2). https://doi.org/10.1542/peds.2016-1485

Makin, E., & Davenport, M. (2016). Evaluation of the acute abdomen. Paediatrics and Child Health, 26(6), 231–238. https://doi.org/10.1016/j.paed.2016.01.006.

Verhagen, L., & De Groot, R. (2014). Dengue in children. Journal Of Infection, 69, 77-86. https://doi.org/10.1016/j.jinf.2014.07.020

Eslava Schmalbach, J. H., Guevara Cruz, Ó. A., Gómez Cusnir, P. L., & Sastre Cifuentes, R. E. (2014). Semiología Quirúrgica. Universidad de Colombia

Hutson, J. M., & Beasley, S. W. (1988). The Surgical Examination of Children (2a. ed.). Springer.

Helbling, R., Elisa Conficconi, E., Wyttenbach, M., Benetti, C., Simonetti, G. D., Bianchetti, M. G., Hamitaga, F., Lava, S. A. G., Fossali, E. F., & Milani, G. P. (2017). Acute Nonspecific Mesenteric Lymphadenitis: More Than "No Need for Surgery”. BioMed Research International, 2017, 1-4. https://doi-org.ezproxy.javeriana.edu.co/10.1155/2017/9784565

DiMeglio, L. A., Evans Molina, C., & Oram R. A. (2018). Type 1 diabetes. The Lancet, 10138, 2449-2462. https://doi.org/10.1016/S0140-6736(18)31320-5

Almaramhy, H., & Al-Zalabani A. (2019). The association of prenatal and postnatal macrolide exposure with subsequent development of infantile hypertrophic pyloric stenosis: a systematic review and meta-analysis. Ital J Pediatr, 45(1), 1-9. https://doi.org/10.1186/s13052-019-0613-2

Biner, B., Oner, N., Celtik, C., Bostancioğlu, M., Tunçbilek, N., Güzel, A., & Karasalihoğlu, S. (2006). Ceftriaxone-associated Biliary Pseudolithiasis in Children. J Clin Ultrasound, 34(5), 217-22. https://doi.org/10.1002/jcu.20228

Rojas Soto, E., & Sarmiento Quintero, F. (1994). Pediatría, Diagnóstico Y Tratamiento. Pediatría, Diagnóstico Y Tratamiento. Editorial Presencia Ltda.

Iyer, R., & Nallasamy, K. (2018). Child with Abdominal Pain. Indian J Pediatr, 85(1), 71-76. https://doi.org/10.1007/s12098-017-2447-5

Brugha, R., Marlais, M., & Abrahamson, E. (2018). Paediatric Clinical Examination Made Easy. Elsevier.

Kara, T., & Evans, H. M. (2017). Abdominal examination. J Paediatr Child Health, 51(2), 132-4. https://doi.org/10.1111/jpc.12845

Golledge, J., Toms, A. P., Franklin, I. J., Scriven, M. W., & Galland, R. B. (1996). Assessment of peritonism in appendicitis. Ann R Coll Surg Engl, 78(1), 11-14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2502643/pdf/annrcse01599-0019.pdf

Idris, S. A., Shalayel, M. H., Awad, Y. O., Idris, T. A., Ali, A. Q., & Mohammed, S. A. (2009). The sensitivity and specificity of the conventional symptoms and signs in making a diagnosis of acute appendicitis. Sudan JMS, 4(1), 55-61. https://doi.org/10.4314/sjms.v4i1.44876

Walson, J., & Berkley, J. (2018). The impact of malnutrition on childhood infections. Current Opinion in Infectious Diseases, 31(3), 231-236. https://doi.org/10.1097/qco.0000000000000448

Pozo Román, J., & Muñoz Calvo, M. T. (2011). Pubertad precoz y retraso puberal. Pediatr Integral, 15(6), 523-543. https://repositorio.uam.es/bitstream/handle/10486/668949/pubertad_pozo_PI_2011_pp523-543.pdf?sequence=1

Bennett, D. H., Tambeur, L. J., & Campbell, W. B. (1994). Use of coughing test to diagnose peritonitis. BMJ, 308(6940). https://dx.doi.org/10.1136%2Fbmj.308.6940.1336

Chandrasekharan, P., Rawat, M., Madappa, R., Rothstein, D., & Lakshminrusimha, S. (2017). Congenital Diaphragmatic hernia – a review. Maternal Health, Neonatology and Perinatoloyg, 3(1). https://doi.org/10.1186/s40748-017-0045-1

Peters, B., Oomen, M., Bakx, R., & Benninga, M. Advances in infantile hypertrophic pyloric stenosis. Expert Review Of Gastroenterology & Hepatology, 2014, 8(5), 533-541. https://doi.org/10.1586/17474124.2014.903799

Apicella, A., Dolcini, A., D’Amato, L., Bencivenga, C., & Silvestri, S. (2019). Cullen's and Grey Turner's signs in unconscious children. J Paediatr Child Health, 55(4), 481. https://doi.org/10.1111/jpc.1_14389

Płotka, A., Wziątek, A., Wachowiak, J., & Derwich K. (2019). Successful Management of a Child With Drug-induced Necrotizing Pancreatitis During Acute Lymphoblastic Leukemia Therapy: A Case Report. J Pediatr Hematol, 41(2), 125–8. https://doi.org/10.1097/mph.0000000000001181

Gutmann, H. D., Ferner, R. E., Listernick, R. H., Korf, B. R., Wolters, P. L., & Johnson, K. J. (2017). Neurofibromatosis type 1. Nature Reviews Disease Primers, 3(1), 1-17.

Jennings, R. W. (2000). Prune Belly Syndrome. Seminars in Pediatric, 9(3), 115-120. https://doi.org/10.1053/spsu.2000.7556

Watanabe, S., Suzuki, T., Hara, F., Yasui, T., Uga, N., & Naoe, A. (2017). Gastroschisis in Newborns: Over 16 Omphalocele Years of Experience from a Single Clinic. Journal of Neonatal Surgery, 6(2), 27. https://doi.org/10.21699/jns.v6i2.530

Ramesh, S., Hariprasath, S., Anandan, G., Solomon, P., & Vijayakumar, V. (2015). Single umbilical artery. Journal of Pharmacy and Bioallied Sciences, 7(5). https://doi.org/10.4103/0975-7406.155815

Fraser, N., Davies, B. W., & Cusack, J. (2006). Neonatal omphalitis: A review of its serious complications. Acta Paediatrica, 95(5), 519-522.

Kelly, K. B., & Ponsky, T. A. (2013). Pediatric Abdominal Wall Defects. Surgical Clinics Of North America, 93(5), 1255-1267. https://doi.org/10.1016/j.suc.2013.06.016

Bourke, M. M., & Silverberg, J. Z. (2019). Acute Scrotal Emergencies. Emergency Medicine Clinics Of North America, 37(4), 593-610. https://doi.org/10.1016/j.emc.2019.07.002

Wood, R. J, & Levitt, M. A. (2018). Anorectal Malformations. Clinics In Colon And Rectal Surgery, 31(02), 61-70. https://doi.org/10.1055/s-0037-1609020

Llanio, R., & Llanio Navarro, R. (2005). Propedéutica clínica y semiología médica. Editorial Ciencias Médicas.

Mealie C. A., Ali R. & Manthey, D. E. (2020). Abdominal Exam [Internet]. Treasure Island: StatPearls Publishing; 2020. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29083767/

Gryskiewicz, J. M. & Huseby, T. L. (1980). The pediatric abdominal examination. Postgrad Med., 67(3), 126-1288, 130, 132. https://doi.org/10.1080/00325481.1980.11715397

Valdés Armenteros, R. (2003). Examen clínico al recién nacido. Editorial Ciencias Médicas.

Almeflh, W., AlRaymoony, A., AlDaaja, M. M., Abdullah, B., & Oudeh, A. (2019). A Systematic Review of Current Consensus on Timing of Operative Repair Versus Spontaneous Closure for Asymptomatic Umbilical Hernias in Pediatric. Med Arch., 73(4): 268-271. https://doi.org/10.5455/medarh.2019.73.268-271

Wolf A. D., & Lavine, J. E. (2000). Hepatomegaly in Neonates and Children. Pediatrics in Review, 21(9), 303-310. https://doi.org/10.1542/pir.21-9-303

Kara, T., & Evans, H. M. (2015). Abdominal examination. J Paediatr Child Health, 51(2), 132-134. https://doi.org/10.1111/jpc.12845

Palmer, L. S. (2013). Hernias and Hydroceles. Pediatr Rev., 34(10), 457-464. https://doi.org/10.1542/pir.34-10-457

García Aguado, J. (2010). Estudio del paciente con adenopatías periféricas. Curso de actualización en pediatría. Madrid: Exlibris Ediciones; 2010. 31–42

Deng, T., Zhang, X., Wang, G., Duan, S., Fu, M., Zhong, J., Li, J., & Jiang, X. (2019) Children with Cryptorchidism Complicated by Testicular Torsion: A Case Series. Urol Int., 102(1), 113-117. https://doi.org/10.1159/000493766

Weiss, A. P., & Van Heukelom, J. (2012). Torsion of an Undescended Testis Located in the Inguinal Canal. J Emerg Med., 42(5), 538-539. https://doi.org/10.1016/j.jemermed.2011.05.073

Kumar, V., Matai, P., Prabhu S. P., & Sundeep, P. T. (2020). Testicular Loss in Children Due to Incorrect Early Diagnosis of Torsion. Clinic Pediatr (Phila), 59(4-5), 436-438. https://doi.org/10.1177/0009922820903037

Fujita N, Tambo M, Okegawa T, Higashihara E, Nutahara K. Distinguishing testicular torsion from torsion of the appendix testis by clinical features and signs in patients with acute scrotum. Res Rep Urol. 2017;9:169-174

Childress, K. J., & Dietrich, J. E. (2017). Pediatric Ovarian Torsion. Surg Clin N Am., 97(1), 209-221. https://doi.org/10.1016/j.suc.2016.08.008

Eskander, R. N., & Bristow, R. E. (2012). Adnexal Masses in Pediatric and Adolescent Females: A Review of the Literature. Curr Obstet Gynecol Rep., 1, 25–32. https://doi.org/10.1007/s13669-011-0001-4

Wang, Y., & Tao, Y. (2015). Diagnosis and treatment of congenital abdominal aortic aneurysm: a systematic review of reported cases. Orphanet Journal Of Rare Diseases, 10(1), 4. https://doi.org/10.1186/s13023-015-0225-x

Mattei, P., & Rombeau, J. (2006). Review of the Pathophysiology and Management of Postoperative Ileus. World Journal Of Surgery, 30(8), 1382-1391. https://doi.org/10.1007/s00268-005-0613-9

Toth, E. (2021). Ostomy Pearls: A CONCISE GUIDE TO STOMA SITING, POUCHING... : Advances in Skin & Wound Care. Retrieved 29 May 2021, from https://journals.lww.com/aswcjournal/Fulltext/2003/05000/Ostomy_Pearls__A_CONCISE_GUIDE_TO_STOMA_SITING,.14.aspx

Di Leo, G., Pascolo, P., Hamadeh, K., Trombetta, A., Ghirardo, S., & Schleef, J. et al. (2019). Gastrostomy Placement and Management in Children: A Single-Center Experience. Nutrients, 11(7), 1555. https://dx.doi.org/10.3390%2Fnu11071555

Berti-Hearn, L., & Elliott, B. (2019). Colostomy Care. Home Healthcare Now, 37(2), 68-78. https://doi.org/10.1097/nhh.0000000000000735

How to Cite

APA

Molina Ramírez, I. ., Valero Halaby, J. J. ., Becerra Pedraza, P. A., Rodríguez López, G. ., Vásquez Torrejano, C. . and Acuña Rivera, J. Y. . (2021). Examen físico abdominal pediátrico. Morfolia, 13(3), 19–43. https://revistas.unal.edu.co/index.php/morfolia/article/view/100004

ACM

[1]
Molina Ramírez, I. , Valero Halaby, J.J. , Becerra Pedraza, P.A., Rodríguez López, G. , Vásquez Torrejano, C. and Acuña Rivera, J.Y. 2021. Examen físico abdominal pediátrico. Morfolia. 13, 3 (Dec. 2021), 19–43.

ACS

(1)
Molina Ramírez, I. .; Valero Halaby, J. J. .; Becerra Pedraza, P. A.; Rodríguez López, G. .; Vásquez Torrejano, C. .; Acuña Rivera, J. Y. . Examen físico abdominal pediátrico. Morfolia 2021, 13, 19-43.

ABNT

MOLINA RAMÍREZ, I. .; VALERO HALABY, J. J. .; BECERRA PEDRAZA, P. A.; RODRÍGUEZ LÓPEZ, G. .; VÁSQUEZ TORREJANO, C. .; ACUÑA RIVERA, J. Y. . Examen físico abdominal pediátrico. Morfolia, [S. l.], v. 13, n. 3, p. 19–43, 2021. Disponível em: https://revistas.unal.edu.co/index.php/morfolia/article/view/100004. Acesso em: 4 aug. 2024.

Chicago

Molina Ramírez, Iván, Juan Javier Valero Halaby, Paola Andrea Becerra Pedraza, Geraldine Rodríguez López, Claribeth Vásquez Torrejano, and Javier Yesid Acuña Rivera. 2021. “Examen físico abdominal pediátrico”. Morfolia 13 (3):19-43. https://revistas.unal.edu.co/index.php/morfolia/article/view/100004.

Harvard

Molina Ramírez, I. ., Valero Halaby, J. J. ., Becerra Pedraza, P. A., Rodríguez López, G. ., Vásquez Torrejano, C. . and Acuña Rivera, J. Y. . (2021) “Examen físico abdominal pediátrico”, Morfolia, 13(3), pp. 19–43. Available at: https://revistas.unal.edu.co/index.php/morfolia/article/view/100004 (Accessed: 4 August 2024).

IEEE

[1]
I. . Molina Ramírez, J. J. . Valero Halaby, P. A. Becerra Pedraza, G. . Rodríguez López, C. . Vásquez Torrejano, and J. Y. . Acuña Rivera, “Examen físico abdominal pediátrico”, Morfolia, vol. 13, no. 3, pp. 19–43, Dec. 2021.

MLA

Molina Ramírez, I. ., J. J. . Valero Halaby, P. A. Becerra Pedraza, G. . Rodríguez López, C. . Vásquez Torrejano, and J. Y. . Acuña Rivera. “Examen físico abdominal pediátrico”. Morfolia, vol. 13, no. 3, Dec. 2021, pp. 19-43, https://revistas.unal.edu.co/index.php/morfolia/article/view/100004.

Turabian

Molina Ramírez, Iván, Juan Javier Valero Halaby, Paola Andrea Becerra Pedraza, Geraldine Rodríguez López, Claribeth Vásquez Torrejano, and Javier Yesid Acuña Rivera. “Examen físico abdominal pediátrico”. Morfolia 13, no. 3 (December 8, 2021): 19–43. Accessed August 4, 2024. https://revistas.unal.edu.co/index.php/morfolia/article/view/100004.

Vancouver

1.
Molina Ramírez I, Valero Halaby JJ, Becerra Pedraza PA, Rodríguez López G, Vásquez Torrejano C, Acuña Rivera JY. Examen físico abdominal pediátrico. Morfolia [Internet]. 2021 Dec. 8 [cited 2024 Aug. 4];13(3):19-43. Available from: https://revistas.unal.edu.co/index.php/morfolia/article/view/100004

Download Citation

Article abstract page views

3814

Downloads

Download data is not yet available.