Left sided abdominal pain in childhood.

In a paediatric surgical practice over a 10 year period, 59 children presenting with left sided abdominal pain, acute or chronic, were investigated and followed up to identify the cause. Only two were found to have an identifiable surgically significant cause, one being hydronephrosis and the other being congenital uterine abnormality. Other causes suspected were Mittelschmerz, faecal retention or gastroenteritis, functional, abdominal migraine and allergy. Two boys developed torsion of the testis within 2 years of an episode of left sided abdominal pain. This is considered significant and the examination of boys with left sided abdominal pain should include careful scrutiny of the testis and assessment of its disposition with the boy standing. In both sexes investigation should focus initially on the urinary tract.