כאב ברביע הימני התחתון אצל ילדים

What is right lower quadrant pain?

Pain in the tummy (abdomen) is a common problem in children. The right side of the lower part of the tummy (below the tummy button) is called the right lower quadrant of the abdomen. The main issue when pain is in this area is whether or not the diagnosis is acute appendicitis, but there are many other possible causes.

When pain comes on suddenly it is called 'acute'. Acute right lower quadrant pain may be caused by (see links for further details):

• דלקת תוספתן חריפה.

• גסטרואנטריטיס.

• זיהום בדרכי השתן.

• Groin (inguinal) hernia.

• תסביב האשך.

• דלקת בלוטות הלימפה המזנטריות.

• Obstruction of the bowel (intestinal obstruction), eg, intussusception, or volvulus.

When pain comes on more gradually and is more persistent (chronic) or comes and goes (recurrent), the possible causes of right lower quadrant pain include:

• עצירות.

• Abdominal migraine (recurrent episodes of abdominal pain without the typical migraine headache. The pain is more often in the centre of the abdomen, in the area around the tummy button).

• תסמונת המעי הרגיז (more common in adults).

• מחלת מעי דלקתית.

• מחלת צליאק.

Common causes of right lower quadrant pain in children

In children common causes of right lower quadrant (RLQ) pain include:

עצירות

• Very common in children.

• Means passing hard stools (faeces), with difficulty, less often than normal.

• May cause RLQ pain but more commonly causes pain on the left, over the last part of the colon (descending colon).

See separate leaflet called Constipation in Children for more information.

גסטרואנטריטיס והרעלת מזון

• Cause diarrhoea.

• May also cause the child to be sick (vomit) and have crampy tummy (abdominal) pains.

• Pain may be anywhere in the tummy.

• Pain may ease for a while each time some diarrhoea is passed.

See separate leaflets called Gastroenteritis in Children ו Food Poisoning in Children for more information.

אי סבילות ללקטוז

• Leads to bloating, tummy pain, wind and watery stools after drinking milk.

• Lactose intolerance can sometimes occur for a while after gastroenteritis. The condition gets better when the infection is over and the gut lining heals.

• Some people are born with a tendency to develop it.

See separate leaflet called Lactose Intolerance for more information.

דלקת בלוטות הלימפה המזנטריות

• In children with infections such as colds, glands within the tummy commonly become inflamed giving them tummy ache.

• לילד עשויים להיות תסמינים נוספים של הצטננות, כמו נזלת או כאב גרון.

See separate leaflet called Mesenteric Adenitis for more information.

דלקת התוספתן

• In older children, symptoms will be similar to those in adults (see separate leaflet on right lower quadrant pain).

• Babies may get watery diarrhoea and vomiting.

• Preschool children may just have vague tummy pains and go off their food.

See separate leaflet called Appendicitis for more information.

תסביב האשך

• Occurs when a testicle (testis) twists around in the scrotum.

• זה מתרחש אצל בנים וגברים צעירים, בדרך כלל נערים מתבגרים.

• זה לא רגיל מעל גיל 25 שנים.

• Severe pain that develops quickly.

• זה יכול להשפיע על כל צד.

See separate leaflet called Torsion of the Testis for more information.

מחלת צליאק

• Coeliac disease is caused by a reaction of the gut to gluten. Gluten is found in many foods.

• It can cause poor growth

• הצואה עשויה להיות בהירה, מסריחה וקשה להורדה באסלה.

• כאב לא תמיד מופיע אבל יכול להיות בכל מקום בבטן. הוא נוטה לבוא וללכת.

See separate leaflet called Coeliac Disease for more information.