ACR Appropriateness Criteria® Abdominal Pain-Child.

Creator(s)

• Expert Panel on Pediatric Imaging
• HaiThuy N Nguyen
• Sherwin S. Chan, Children's Mercy HospitalFollow
• Brandon P. Brown
• Brooks D. Cash
• Scott R. Dorfman
• Jason D. Fraser
• Morgan P. McBee
• Helen R. Nadel
• Anh-Vu H. Ngo
• Emily S. Orscheln
• Hannibal Person
• Emily Rose
• Elizabeth J. Snyder
• George S. Wu
• Ramesh S. Iyer

Document Type

Article

Publication Date

4-2026

Identifier

DOI: 10.1016/j.jacr.2026.01.018

Abstract

The range of pathology that can produce abdominal pain in children not only is broad, but can vary with age. Due to the wide differential and the inability for a child to clearly identify and describe the nature of their abdominal pain, diagnostic imaging is often needed. Various clinical scenarios are discussed for a child presenting with acute abdominal pain. Initial imaging studies that are usually appropriate or may be appropriate (based on the best available evidence or expert consensus) for suspected constipation, intussusception, small bowel obstruction without history of surgery, surgical complications, and necrotizing enterocolitis are discussed. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.

Journal Title

J Am Coll Radiol

Volume

23

Issue

4

First Page

700

Last Page

714

MeSH Keywords

Humans; Abdominal Pain; Child; United States; Diagnostic Imaging; Evidence-Based Medicine; Diagnosis, Differential; Societies, Medical; Pediatrics; Child, Preschool; Radiology; Practice Guidelines as Topic

PubMed ID

41701130

Keywords

AUC; Abdomen; Appropriate Use Criteria; Appropriateness Criteria; NEC; bowel obstruction; intussusception; pediatric; postsurgical

Recommended Citation

Expert Panel on Pediatric Imaging, Nguyen HN, Chan SS, et al. ACR Appropriateness Criteria® Abdominal Pain-Child. J Am Coll Radiol. 2026;23(4):700-714. doi:10.1016/j.jacr.2026.01.018