An adolescent with acute abdominal pain and bowel wall thickening.
Arch Dis Child Educ Pract Ed
; 103(1): 22-24, 2018 Feb.
Article
en En
| MEDLINE
| ID: mdl-27756754
ABSTRACT
A 15-year-old girl was admitted with acute crampy abdominal pain and repeated vomiting over the preceding 2â
hours; no fever, diarrhoea or abdominal trauma was reported. She had started oestrogen-progestin contraception 3â
months ago. She had sought medical advice twice in the previous weeks for self-limiting episodes of right hand swelling, without urticaria. On examination, she was unwell and in pain, with severe tenderness in the right lower quadrant, without guarding or rebound tenderness. Bowel sounds were diminished. Blood tests were unremarkable. Two hours after admission, an abdominal ultrasound scanning showed an impressive wall thickening (>1â
cm) of the terminal ileum, caecum and ascending colon (figure 1). Abundant free intraperitoneal fluids in the pelvis and in the hepatorenal recess were present.edpract;103/1/22/EDPRACT2016311823F1F1EDPRACT2016311823F1Figure 1Marked caecal wall thickening evidenced at the ultrasound scanning. QUESTIONS Which of the following is the most likely diagnosis in this patient? Ileocolic intussusceptionGastrointestinal manifestation of Henoch-Schönlein purpuraAbdominal attack of hereditary angioedema (HAE)Acute pancreatitisWhich of the following blood tests may help to confirm the diagnosis? Erythrocyte sedimentation rateC4Serum amylase 36â
IU/LC1-inhibitorHow should this patient be evaluated and treated?Answers are on page âªâªâª.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedades Inflamatorias del Intestino
/
Dolor Abdominal
/
Proteína Inhibidora del Complemento C1
/
Angioedema
Tipo de estudio:
Diagnostic_studies
Límite:
Adolescent
/
Female
/
Humans
Idioma:
En
Revista:
Arch Dis Child Educ Pract Ed
Asunto de la revista:
PEDIATRIA
Año:
2018
Tipo del documento:
Article
País de afiliación:
Italia