What are the contraindications for abdominal exam?

1. Swartz, MH. Textbook of Physical Diagnosis: History and Examination. wb saunders; 2002.

2. Sir Zachary Cope, revised by William Silen. Cope's early Diagnosis of the Acute Abdomen. 15. New York: Oxford University Press; 1979. 32-49.

3. Marin JR, Rodean J, Hall M, Alpern ER, Aronson PL, Chaudhari PP, et al. Trends in Use of Advanced Imaging in Pediatric Emergency Departments, 2009-2018. JAMA Pediatr. 2020 Sep 1. 174 (9):e202209. [Medline].

4. Schacherer N, Miller J, Petronis K. Pediatric blunt abdominal trauma in the emergency department: evidence-based management techniques. Pediatr Emerg Med Pract. 2014 Oct. 11 (10):1-23; quiz 23-4. [Medline].

5. Streck CJ, Vogel AM, Zhang J, Huang EY, Santore MT, Tsao K, et al. Identifying Children at Very Low Risk for Blunt Intra-Abdominal Injury in Whom CT of the Abdomen Can Be Avoided Safely. J Am Coll Surg. 2017 Apr. 224 (4):449-458.e3. [Medline].

6. Inadequacies of Physical Examination as a Cause of Medical Errors and Adverse Events: A Collection of Vignettes.

7. Dinh VA, Frederick J, Bartos R, Shankel TM, Werner L. Effects of ultrasound implementation on physical examination learning and teaching during the first year of medical education. J Ultrasound Med. 2015 Jan. 34 (1):43-50. [Medline].

8. Bundy DG, Byerley JS, Liles EA, Perrin EM, Katznelson J, Rice HE. Does This Child have Appendicits?. JAMA. 2007. 298:438-51.

9. Mahajan L, Wyllie R. Chronic Abdominal Pain of childhood and Adolescence. Wyllie R, Hyams J. Pediatric gastrointestinal Disease: Pathophysiology, diagnosis, management. second. Philadelphia Pa: W.B Saunders; 1999. 4.

10. Matin J, Alpern E. Abdominal Pain in Children. Mills AM, Dean AJ. Emergency Medicine clinics of North America. Elsevier; 2011. 29: 401-428.

11. Ross A, LeLeiko NS. Acute abdominal pain. Pediatr Rev. 2010 Apr. 31(4):135-44; quiz 144. [Medline].

12. McNamara R, Dean AJ. Approach to Acute Abdominal Pain. Mills AM, Dean AJ. Emergency Medicine Clinics of North America. Elsevier; 2011. 29: 159-173.

13. Lowe M, Woolridge D. Normal Newborn Exam, or is it?. Emergency Medicine Clinics of North America. 2007. 29: 921-946.

14. Geifer MJ, Murray KF, Colletti RB. Pathophysiology, diagnosis, and management of pediatric ascites. j Pediatr Gastroenterol Nutr. May 2011. 52:503-13.

15. White MC, Langer JC, Don S, DeBaun MR. Sensitivity and cost minimization analysis of radiology versus olive palpation for the diagnosis of hypertrophic pyloric stenosis. J Pediatr Surg. 1998 Jun. 33(6):913-7. [Medline].

16. Copeland DR, Cosper GH, McMahon LE, et al. Return of the surgeon in the diagnosis of pyloric stenosis. J Pediatr Surg. 2009 Jun. 44(6):1189-92; discussion 1192. [Medline].

17. Adelgais KM, Kuppermann N, Kooistra J, Garcia M, Monroe DJ, Mahajan P, et al. Accuracy of the abdominal examination for identifying children with blunt intra-abdominal injuries. J Pediatr. 2014 Dec. 165 (6):1230-1235.e5. [Medline].

18. Rostas J, Cason B, Simmons J, Frotan MA, Brevard SB, Gonzalez RP. The validity of abdominal examination in blunt trauma patients with distracting injuries. J Trauma Acute Care Surg. 2015 Jun. 78 (6):1095-100 ; discussion 1100 - 1. [Medline].

Simon S Rabinowitz, MD, PhD, FAAP Professor of Clinical Pediatrics, Vice Chairman, Clinical Practice Development, Pediatric Gastroenterology, Hepatology, and Nutrition, State University of New York Downstate College of Medicine, The Children's Hospital at Downstate

Simon S Rabinowitz, MD, PhD, FAAP is a member of the following medical societies: American Academy of Pediatrics, American Association for the Advancement of Science, American College of Gastroenterology, American Gastroenterological Association, American Medical Association, New York Academy of Sciences, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, Phi Beta Kappa, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Eric Dean, DO Resident Physician, Department of Pediatrics, SUNY Downstate Medical Center

Eric Dean, DO is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Kurt E Roberts, MD Assistant Professor, Section of Surgical Gastroenterology, Department of Surgery, Director, Surgical Endoscopy, Associate Director, Surgical Skills and Simulation Center and Surgical Clerkship, Yale University School of Medicine

Kurt E Roberts, MD is a member of the following medical societies: American College of Surgeons, Society of American Gastrointestinal and Endoscopic Surgeons, Society of Laparoendoscopic Surgeons

Disclosure: Nothing to disclose.

Vania L Kasper, MD Clinical Assistant Instructor, Chief Resident, Department of Pediatrics, State University of New York Downstate College of Medicine

Vania L Kasper, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Women's Association

Disclosure: Nothing to disclose.

The authors would like to acknowledge helpful discussions and a review of the chapter by Drs Steven Schwarz and Stanley Fischer.