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Forum Name: Pediatric Topics

Question: Child with severe back pain - gastroenteritis


 pollyby - Tue Nov 27, 2007 7:51 am

HI,

This is a bit of an unusual one I think (and sorry a bit long also)

For the last 6 months or more my 3 year old son has now and again complained about his back being sore. Usually it's just a fleeting moment and then he goes back about his business. On a few occasions when he's been ill (e.g ear/ throat infections) he would tend to mention his back more than usual and even more so than the supposed infected part!

Last Thursday he became ill quite suddenly and was screaming in agony with the pain in his back and head and then vomited after which he perked up a bit. i took him to our GP who didn't even look or feel his back or tummy but rather looked in his ears and throat, diagnosed an ear and throat infection and precribed anti-biotics. By the next morning the little one had sever diarrhoea so I stopped the anti b. For the next few days he continued to have V & D and back pain. By Saturday he was screaming (and screaming and screaming!) about the pain in his back and arching his back constantly so we took him to another GP who gave him a thorough check and diagnosed gastroenteritis. She said the back pain had her stumped and just considered it to be an unusual presentation of the GE.

He has now recovered thankfully but I am concerned about this back pain business. How could a child have severe V and D for 4 days and not once mention a pain in his tummy? I could literally feel his tummy go into spasms that would have anyone else doubled over and yet he arched his back and screamed about the pain there! I am wondering if he has some strange pain perception pathways...or something ... I'm stumped to be honest! This child has never ever mentioned a pain in his tummy. Even this morning he said his back was sore just before he went to do no2. Is it possible that his normal internal pain perception is referred to his back in some way? Should I pursue this medically and if so in what direction? I am worried that this could cause problems if there were something more serious going on e.g appendicitis and was missed because of the unusual presentation. If there is something amiss Should it a least be in his notes so that it is taken seriously next time. Though GP2 (on call doc) did a good job GP1 (our family GP) was incredibly dismissive. Time for a change I think.

Thank you for taking the time to read this.
 Dr. Chan Lowe - Tue Nov 27, 2007 11:49 pm

User avatar Hi Pollyby,

Unlike adults, children typically do not get back pain. His vomiting symptoms do fit the diagnosis of acute gastroenteritis.

It would be pretty atypical for gastroenteritis to cause back pain but not impossible.

I'd suggest having your son see his pediatrician again. The back pain issue should probably be evaluated a bit more. Spine x-rays are a simple place to start.

If the pain continues, seeing an orthopedic specialist may be helpful.

Best wishes.
 pollyby - Wed Nov 28, 2007 5:03 am

Thank you. That was my feeling too.

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