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Signs of Urinary Stones May Be Hard to Detect in Children

Recurrent abdominal pain and family history of urolithiasis suggest possibility of urinary stones

THURSDAY, Nov. 12 (HealthDay News) -- In children younger than 8 years of age, the origin of recurrent abdominal pain may be overlooked and ineffective procedures performed, without consideration of urolithiasis, according to a study completed in Italy and published online Nov. 9 in Pediatrics.

Cesare Polito, M.D., of the Second University of Naples in Italy, and colleagues analyzed data from 100 patients, aged 3 to 18 years, with functional or organic recurrent abdominal pain, as well as 270 controls.

The researchers found that 37 patients underwent abdominal ultrasound at least two months before the diagnosis of urolithiasis, without finding urinary stones. Only 35 patients had gross or microscopic hematuria at their first visit. Sixteen percent of patients had previously undergone an appendectomy, compared to 1.5 percent of controls. Among patients younger than 8 years, 69 percent had central diffuse pain and 29 percent had lateral flank pain. In older children, these findings were 11 and 85 percent, respectively.

"It seems advisable to perform at least two renal ultrasound examinations one to two years apart and three nonconsecutive complete evaluations of urinary solute excretion abnormalities in outpatient children with recurrent abdominal pain and a family history of urolithiasis, even in the absence of specific urinary signs and symptoms, and in younger patients, although the pain may be central or diffuse in the whole abdomen," the authors write.

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