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Pediatrics 7

A previously healthy 10-year-old girl is brought to the emergency department because of a 2-day history of increasingly severe abdominal pain. She has had anorexia for the past day. She has no history of serious illness and does not take any medications. Her temperature is 38.5°C (101.3°F), pulse is 105/min, blood pressure is 95/65 mm Hg, and respirations are 20/min. On physical examination, she appears well developed and well nourished. Cardiopulmonary examination shows no abnormalities. Abdominal examination shows localized tenderness over the left lower quadrant, and there is guarding at McBurney’s point. Bowel sounds are decreased. Laboratory studies show a leukocyte count of 15,000/mm3 and hemoglobin concentration of 13.0 g/dL and. Urinalysis shows no abnormalities.

Which of the following is the most appropriate next step in management?

  • A) Admission to the hospital for observation and serial examinations
  • B) CT scan of the abdomen
  • C) Measurement of serum C-reactive protein concentration
  • D) Surgical evaluation
  • E) Ultrasonography of the abdomen and pelvis

Authors

Lloyd Taylor

Editor

Dr. Ted O'Connell

Last updated

Jun 09, 2024

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