Evaluation of Abdominal Pain in Children with Mumps

Diagnostic Testing

A complete blood count can assess for leukocytosis, suggesting infection or inflammation, in children with abdominal pain and suspected mumps, according to the Infectious Diseases Society of America 1
For right lower quadrant pain suspected to be appendicitis in children, the American College of Radiology recommends ultrasound as the initial imaging study to avoid radiation exposure 2, 3
Abdominal ultrasound can evaluate the pancreas, liver, and gallbladder in cases of diffuse abdominal pain or suspected pancreatitis, as suggested by the American Academy of Pediatrics 4
CT may be considered if ultrasound is inconclusive and clinical suspicion for surgical pathology remains, according to the American College of Emergency Physicians 5

The American Academy of Pediatrics recommends that pain control should not be withheld while awaiting diagnosis, as it does not mask symptoms or affect diagnostic accuracy, with a strength of evidence level of strong recommendation 6, 7
For mild to moderate pain in children with abdominal pain and suspected mumps, the American Academy of Pediatrics suggests oral nonsteroidal anti-inflammatory drugs (NSAIDs) if no contraindications exist, with a moderate level of evidence 7
For severe pain, the American Academy of Pediatrics recommends intravenous opioid analgesics titrated to effect, with a high level of evidence 7
In cases of confirmed pancreatitis, the American Academy of Pediatrics recommends supportive care with IV fluids, pain management, and bowel rest as needed based on severity, with a moderate level of evidence 4, 6
If appendicitis is suspected, the Infectious Diseases Society of America recommends appropriate antibiotic therapy based on pediatric dosing guidelines, including options such as aminoglycoside-based regimens, carbapenem, β-lactam/β-lactamase inhibitor combinations, or advanced-generation cephalosporin with metronidazole, with a strong level of evidence 1, 8

The American Academy of Pediatrics suggests that repeated physical examinations by the same physician are valuable if diagnosis is not clear after initial evaluation, although this is based on low-level evidence 6, 7
The American Academy of Pediatrics also notes that pain medications can make children more comfortable and aid in diagnosis by allowing better examination and diagnostic testing, with a moderate level of evidence 6, 7
Hospitalization should be considered for children with severe symptoms or those requiring IV hydration or pain management, according to the Infectious Diseases Society of America, with a strong level of evidence 1