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Chronic pelvic pain in children and adolescents 

Chronic pelvic pain in children and adolescents
Chapter:
Chronic pelvic pain in children and adolescents
Author(s):

Susan L. Sager

and Marc R. Laufer

DOI:
10.1093/med/9780199642656.003.0030
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date: 18 June 2019

Pain due to pelvic pathology in children and adolescents is often described as abdominal pain, and frequently coexists with gastrointestinal symptoms due to neuronal cross talk and viscero-viscero or viscero-somatic convergence of sensory afferents. Dysmenorrhea is highly prevalent among adolescents yet is underreported. Like many chronic conditions where repetitive noxious stimuli are present, dysmenorrhea can be associated with central sensitization of pain pathways and visceral hyperalgesia. In this chapter the components of a menstrual history, the importance of obtaining a menstrual history in adolescents with abdominopelvic pain, and the indications for referral to an adolescent gynaecologist are discussed. Endometriosis should be considered in the differential diagnosis of all females with chronic abdominopelvic pain of undetermined aetiology once the benchmark of thelarche has been met. Other overlooked causes of abdominopelvic pain include intercostal or subcostal neuralgias, nerve compression, and abdominal cutaneous nerve entrapment. A multidisciplinary approach to treatment of the patient with chronic abdominopelvic pain is discussed.

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