The early diagnosis of acute abdominal emergencies in infancy and early childhood

It is not generally appreciated that acute abdominal emergencies are common in infancy and early childhood. Although chemotherapy and antibiotics, improved techniques in pre- and post-operative care, and better anaesthesia have been reponsible for a steady and reassuring decline in the annual mortality rate from these emergencies, there is still much room for improvement. The reduction in mortality has not equalled that found in adults, and disconcerting facts are the alarming death rate from neonatal obstructions still prevalent in many centres, the frequency of irreducible intussusception, and the persistently high fatality-rate from acute appendicitis in children under the age of 5 years.It is the purpose of this paper to ascertain the causes of the higher mortality figures in small children, and to consider the distinctive clinical features of the commoner conditions which present as acute abdominal emergencies in childhood. The data, which are based mainly on personal experience, are correlated with the views expressed in current literature and illustrated by an analysis of 314 abdominal emergencies treated in our Children's Surgical Department during the 2-year period January 1953 to December 1954