Urolithiasis and abdominal pain in children. According to a study published in the December 2009 issue of Pediatrics, urolithiasis is often overlooked as a cause of recurrent abdominal pain in children. The researchers suggest that a correct diagnosis in children is difficult for three main reasons: painful urination and blood in the urine can occur sporadically; the location of urolithiasis-associated pain is often diffuse rather than specific, particularly in younger children; and calculi aren't always present on imaging, especially when stones have already passed. Such difficulties with diagnosis may also result in unnecessary appendectomy (in the study group, 16% of children had had appendectomies, compared with 1.5% in the control population). A family history of stones and abdominal pain occurring infrequently (four or fewer days per month) may be a signal to clinicians of the presence of urolithiasis, even in the absence of dysuria and hematuria.