Assignment task:
Listen A 15-year-old boy presents to your office with a chief complaint of persistent abdominal pain and nausea. He has no past medical history. His review of systems is remarkable for diarrhea, fatigue, cramping abdominal pain, nausea, fevers, and occasional rectal bleeding. You note in the patient's chart that he had been growing along the 70th percentile on his growth curve, but then at the age of 12, his growth velocity declined and his weight is now at the 25th percentile. On physical examination, auscultation of the abdomen reveals normoactive bowel sounds; the abdomen is nondistended and nontender to palpation. Perianal examination is significant for a skin tag. The rest of the physical examination is within normal limits. Serum laboratory values are significant for leukocytosis, anemia, and an elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Questions What is the most likely diagnosis? What is the best diagnostic test for this disorder?