Pediatric bilateral lower extremity curling: The main manifestation of an intestinal spasm attack is persistent, unsettling crying and fussing. The main manifestation is crying and restlessness, which may be accompanied by vomiting, flushed cheeks, tumbling, and curling of both lower limbs.
Common causes are: i. Gastrointestinal factors.
1. Excessive intestinal gas production.
There are four major sources of intestinal gas: swallowed gas; neutralized gastric acid production; diffused from the blood and bacterial fermentation production.
2. Increased intestinal power.
3. Gastrointestinal hormones.
4. Dietary factors. Some studies have shown that the occurrence of intestinal cramps in breastfed children is related to the mother’s milk consumption, and food allergy may be a cause of intestinal cramps.
5, other factors.
Second, non-gastrointestinal factors.
Intestinal spasms are based on recurrent episodes and lack of abnormal abdominal signs in the interictal period. History of past seizures is helpful for diagnosis. And it is important to exclude organic disorders first. In particular, it can be easily confused with most surgical emergencies and should be differentiated. Common diseases such as biliary ascariasis, ascariasis intestinal obstruction, appendicitis, intussusception, and less common intestinal torsion, intestinal perforation, pancreatitis, incarcerated hernia, congenital intestinal malrotation, biliary spasm, cholecystitis, renal calculi, small common bile duct cyst abdominal pain and distal ileal diverticulum abdominal pain should be carefully differentiated and necessary investigations should be performed. Some medical diseases can also cause heavier abdominal pain, such as when lobar pneumonia starts, when acute heart failure leads to rapid liver enlargement, etc. If the child is uncooperative and the examination is unsatisfactory, appropriate sedation can be applied and the abdomen can be carefully examined after he/she falls asleep and the heart and lungs can be auscultated. The abdominal pain of allergic purpura is actually also allergic intestinal spasm, if rash appears at the same time, it can be distinguished from simple intestinal spasm, but it should be noted that intestinal spasm of purpura can sometimes be secondary to intestinal entrapment, which cannot be ignored. It is also important to note that some small infants with recurrent episodes of intestinal spasms can suddenly develop intussusception after a few days. Occasionally, abdominal tetanus is seen, and the clinical manifestation is spasmodic abdominal pain, but it is abdominal muscle spasm rather than intestinal spasm. Abdominal epilepsy manifests as sudden onset abdominal cramps, mostly around the umbilicus, sometimes in other areas, lasting from several minutes to several hours, with fewer recurrent seizures, normal abdominal examination, and epileptic changes in the EEG. Repeated abdominal examinations without fixed pressure pain and swelling, repeated stool examinations without worm eggs and occult blood, no abnormalities in chest cardiopulmonary auscultation, no abnormal findings in necessary ECG and EEG, and other causes should also be considered when there are no abnormalities in X-ray chest and abdominal examinations. For example, crying during infancy may be due to hunger, discomfort due to diapers covered with urine and feces, or discomfort in other parts of the body and non-painful reasons such as needing to be held, etc. Sometimes abdominal pain is caused by mental factors such as trauma and panic.