Silent and deadly: Abdominal catastrophe in the nonverbal adolescent patient

Abstract

Pediatric care providers are often faced with the challenge of providing for patients who are nonverbal or have trouble communicating. This difficulty in communication extends into the adolescent population for some with chronic health conditions, such as cerebral palsy. Because they cannot communicate well, early warning signs of life threatening processes are important to notice. If these are dismissed, it may lead to suboptimal outcomes in this patient population. We present a case series of four adolescent males with communicative difficulties and abdominal pathology. We characterize a relatively short latency between recognized onset of symptoms and exploratory laparotomy, and suggest further investigation into early warning signs of impending disaster in this patient population.

Keywords

• Cerebral palsy
• Abdominal catastrophe
• Communication