Abdominal pain (general paediatrics)

​​​​​​Emergency

If any of the following are suspected, seek emergency medical advice or refer the patient to the emergency department (via ambulance if necessary)

  • Acute, severe abdominal pain with any of the following features:
    • Appendicitis
    • Bowel obstruction (i.e. bilious vomiting, significant distention, lack of passage of flatus)
    • Intussusception
    • Irreducible hernia
    • Non-gastrointestinal concerns (e.g. diabetic ketoacidosis, pneumonia, myocarditis)
    • Peritonism
    • Pregnancy complications, ectopic pregnancy or ovarian torsion
    • Testicular torsion
  • Dehydration, shock or suspected sepsis

Note: a child with diabetic ketoacidosis and pneumonia often present with abdominal pain as
their presenting symptom​

When public outpatient services are not routinely provided

  • Abdominal pain with a gynaecological cause
  • Constipation without trial of medical treatment ​​

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.​​

  • Recurrent abdominal pain with any of the following features:
    • Anaemia
    • Elevated inflammatory markers (i.e. raised platelet count, C-reactive protein, erythrocyte sedimentation rate and/or reduced albumin) and stool MCS or PCR negative for infection
    • Faltering growth or unexplained weight loss
    • Significant impact on activities of daily living and unable to attend school
    • Suspected inflammatory bowel disease or raised faecal calprotectin
    • Tissue transglutaminase IgA (TTG IgA) > 10 x upper limit normal (ULN)


Note: If urgent assessment is clinically indicated within 1 week, consider contacting the on-call paediatrician

​Category 2
Recommended to be seen within 90 calendar days.
  • Associated persistent non-bloody diarrhoea and
    non-infectious aetiology, particularly if nocturnal
  • Constipation not responding to medical treatment
  • Recurrent abdominal pain with any of the following features:
    • Iron deficiency
    • Significant impact on activities of daily living and
      school attendance (or partial school attendance)
    • Recurrent vomiting​
​Category 3

Recommended to be seen within 365 calendar days.

  • ​​Recurrent abdominal pain without features listed in Category 1 or 2​

Information to include within a referral

Required

  • Reason for referral
  • Details of the presenting condition, including symptoms and their duration, and impact on activities of daily living and school attendance
  • Provisional diagnosis
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • Current weight, height, head circumference
    • Growth charts or any previous measurements
    • C-reactive protein (CRP)
    • Full blood count (FBC)
    • Iron studies
    • Liver function test (LFT)
    • Lipase or amylase
    • Urinalysis
    • Coeliac serology: tissue transglutaminase IgA (TTG IgA), total IgA (where possible) with or without anti-endomysial antibody (EMA) or deaminated gliadin peptide IgG (DGP)
    • Stool MCS, PCR and microscopy
    • Faecal calprotectin (if inflammatory bowel disease suspected and aged > 4 years)
    • Abdominal ultrasound or other relevant imaging​

If available

  • ​​Nil

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.

Current as at: Monday 23 March 2026
Contact page owner: System Purchasing