Case 1: Recurrent abdominal pain in an adolescent girl
| Autor: | Jason A Silverman, Fotini D Kavadas, Sangeeta Jain, Alfred K. Yeung |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Abdominal pain medicine.diagnostic_test Respiratory rate business.industry Sigmoid colon Tachypnea Surgery medicine.anatomical_structure Erythrocyte sedimentation rate Abdominal examination Pediatrics Perinatology and Child Health Ascites medicine Abdomen medicine.symptom business Clinician’s Corner |
| Popis: | A 12-year-old girl presented to the emergency department with a three-day history of worsening, colicky periumbilical and lower abdominal pain. Associated symptoms included anorexia, nausea and nocturnal awakening. This was preceded by two days of upper respiratory tract infection symptoms including malaise, cough and fever. Vital signs demonstrated fever (38.8°C), tachycardia (heart rate 148 beats/min) and tachypnea (respiratory rate 28 breaths/min), but normal blood pressure and oxygen saturation on room air. Abdominal examination demonstrated tenderness in the mid and left lateral abdomen, with palpable fullness in the left lower quadrant. Elevated white blood cell count (15.7×109/L), platelet count (426×109/L), C-reactive protein level (17 mg/L [161.9 nmol/L]), erythrocyte sedimentation rate (16 mm/h) and normal serum albumin were noted. Abdominal ultrasound identified marked ascites and isolated bowel wall thickening of the sigmoid colon. The patient was admitted for observation. Gastroenterology and Pediatric Surgery were consulted regarding the abdominal pain and ultrasound findings. On further history, it was discovered that the patient had a five-year history of stereotypical recurrent abdominal pain. These episodes were much milder than at the time of presentation, and they occurred up to twice per month, resolving spontaneously within two days. Further history suggested the underlying diagnosis. |
| Databáze: | OpenAIRE |
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