E1194. MOCK BOARDS: Mnemonic for Acute Abdominal Pain in Children
Authors
David Lee;
David Geffen School of Medicine at UCLA
Alvin Chan;
David Geffen School of Medicine at UCLA
Soni Chawla;
David Geffen School of Medicine at UCLA; Olive View-UCLA Medical Center
Background
Acute abdominal pain is highly prevalent in the pediatric population. While the history and physical examination may efficiently reveal the diagnosis, there are innumerable etiologies of acute abdominal pain that warrant further evaluation with laboratory or imaging studies. Plain abdominal radiography and computed tomography are powerful imaging modalities that can not only narrow the differential diagnosis, but also expedite intervention for true surgical emergencies. In this work, we present the mnemonic, MOCK BOARDS, as a systematic approach to survey abdominal imaging for common causes of acute abdominal pain in children.
Educational Goals / Teaching Points
Utility of imaging for acute pediatric abdominal pain, review of common causes of acute abdominal pain, and application of MOCK BOARDS mnemonic in the radiographic assessment of acute abdominal pain.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Masses: Wilm’s tumor, neuroblastoma, ovarian serous cystadenoma, immature ovarian teratoma, among several others. Organomegaly: Hepatomegaly and splenomegaly due to infection, cancer, and inflammatory etiologies. Calcifications: Calculi in the urinary tract, gallstones, appendicoliths, splenic granulomas, or calcifications in tumors, such as ovarian teratomas. Krazy: Foreign objects of various densities can be visualized on plain radiography. Foreign body emergencies include sharp or long objects, button batteries, and multiple magnets. Bowel Obstruction: Obstruction caused by acute processes, adhesions, cancer, and strictures, best evident by bowel dilation and air-fluid levels. Air under the Right hemi-Diaphragm: Pneumoperitoneum is a true medical emergency as a result of bowel perforation. Stool: Stool burden and Some other entities such as necrotizing enterocolitis, diverticulitis, inflammatory bowel disease, and other surgical emergencies, should be on the differential diagnosis. Stercoral proctocolitis is a rare complication caused by rectal impaction.
Conclusion
The MOCK BOARDS mnemonic offers an effective and memorable way to systematically identify key imaging findings for the broad presentations of acute abdominal pain in the pediatric population.
