Abdominal Pain and Fever in Children: When to Seek Help

Abdominal pain and vomiting followed by fever the next day?

Hello Dr.
Lin, my child (12 years old) started complaining of abdominal pain around 5 PM on January 26.
Initially, I thought it was just due to overeating, so I advised him to skip dinner.
He vomited for the first time at that moment, and then around 7 PM he vomited again, still complaining of stomach pain (the pain was confirmed to be located above and below the navel).
He vomited a third time around 8 PM.
Later, he complained of dizziness and fell asleep normally.
I monitored his temperature every two hours that night, which was around 37 degrees Celsius.
On the morning of January 27, he started to have a fever, peaking at 38.6 degrees Celsius.
After rehydrating, his temperature fluctuated between 37.9 and 38.4 degrees Celsius.
Due to the current pandemic situation, I am unable to take him for an in-person consultation, and I have no history of exposure to COVID-19.
Should I take him to a local hospital for evaluation, or can we continue to monitor him and wait for his immune system to recover? Thank you for your assistance.

Yen, 10~19 year old female. Ask Date: 2022/01/27

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, a 12-year-old child is experiencing abdominal pain, vomiting, fever, and dizziness.
There are signs of infection in the body.
In cases of gastroenteritis, it is important to pay attention to hydration and electrolyte replenishment, as well as to maintain a light diet.
If abdominal pain, fever, vomiting, dizziness, or altered mental status persist, or if the abdominal pain shifts suggesting appendicitis or signs of peritonitis occur, it is recommended to seek emergency medical attention.
Wishing you health and safety! Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Gastroenterology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2022/01/27

More Info

When it comes to abdominal pain and fever in children, it is crucial to approach the situation with caution and awareness of the potential underlying causes. In your case, your 12-year-old child is experiencing abdominal pain, vomiting, and fever, which can be indicative of various conditions ranging from mild to serious.

Understanding the Symptoms
1. Abdominal Pain: The location of the pain is essential. Pain around the belly button (periumbilical pain) can be associated with several conditions, including gastrointestinal issues (like gastroenteritis), appendicitis, or even urinary tract infections. The fact that your child has vomited multiple times adds another layer of concern, as this could indicate a more severe gastrointestinal disturbance.

2. Vomiting: Frequent vomiting can lead to dehydration, especially in children. It is essential to monitor your child's fluid intake and output. If they are unable to keep fluids down or show signs of dehydration (such as dry mouth, decreased urine output, or lethargy), medical attention is necessary.

3. Fever: A fever can indicate an infection. In children, a fever of 38.6°C (101.5°F) is significant and warrants attention, especially when accompanied by other symptoms like abdominal pain and vomiting.

When to Seek Medical Help
Given the symptoms you've described, here are some guidelines on when to seek medical attention:
- Persistent Symptoms: If the abdominal pain continues to worsen or does not improve, it is essential to seek medical help.
- Severe Pain: If your child exhibits severe abdominal pain, especially if it is localized (e.g., in the lower right quadrant, which could indicate appendicitis), immediate medical evaluation is necessary.

- Signs of Dehydration: If your child shows any signs of dehydration, such as dry lips, lack of tears, or significantly reduced urine output, you should seek medical care.

- High Fever: If the fever persists above 38.5°C (101.3°F) for more than a few hours or is accompanied by other concerning symptoms (like rash, difficulty breathing, or severe lethargy), it is advisable to consult a healthcare provider.

- Change in Behavior: If your child becomes increasingly lethargic, irritable, or unresponsive, this is a medical emergency.

Home Care and Monitoring
While you are monitoring your child's symptoms at home, ensure they stay hydrated. Offer small sips of clear fluids, such as water or an electrolyte solution. Avoid solid foods until vomiting subsides.
If your child’s condition improves, continue to monitor their symptoms closely. If they begin to show signs of recovery, such as reduced pain, decreased vomiting, and a return of appetite, you may continue to observe at home. However, if symptoms persist or worsen, do not hesitate to seek medical attention.

Conclusion
In summary, while some cases of abdominal pain and fever can resolve on their own, the combination of symptoms your child is experiencing—abdominal pain, vomiting, and fever—warrants careful monitoring. If there is any doubt about their condition or if symptoms worsen, it is always better to err on the side of caution and consult a healthcare professional. Your child's health and well-being are paramount, and timely medical intervention can make a significant difference in outcomes.

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