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Organic causes, although rare, must always be considered. Severe colicky abdominal pain alternating with calm, pain-free periods. Abdominal x-ray Barium enema. History of spitting up, arching, or crying after feedings. Chest x-ray ECG Ultrasonography. Swollen erythematous asymmetric scrotum, absent cremasteric reflex.

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Of these, potential life threats include heart failureintussusceptionvolvulus, meningitis also see Bacterial Meningitis in Infants Over 3 Months of Age and Neonatal Bacterial Meningitisand intracranial bleeding due to head trauma.

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Past medical history should note previous episodes of crying and conditions that can potentially predispose to crying eg, history of heart disease, developmental delay. Parental concern is an important variable. The corneas are stained with fluorescein and examined with a blue light to rule out corneal abrasion, and the fundi are examined with an ophthalmoscope for signs of hemorrhage. Examination begins with a review of vital signs, particularly for fever and tachypnea. Of these, potential life threats include heart failureintussusceptionvolvulus, meningitis also see Bacterial Meningitis in Infants Over 3 Months of Age and Neonatal Bacterial Meningitisand intracranial bleeding due to head trauma.

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