Case Study - GI
A 10-year-old girl you follow in your primary care clinic presents today with abdominal pain. Her mother reports that she has been complaining about this pain for 5 days.
Associated Signs and Symptoms: vomiting 2x this morning.
Medications: None
Allergies: None
Social History: Patient is the oldest of four siblings with a 5-year-old brother and a 3-year-old and 8 year old sister. Other family members are well. Patient attends school. Mother is not sure if anybody at school has been sick.
CC: "My daughter has a lot of belly pain."
Physical exam:
Vitals: Blood pressure 100/76; pulse rate 100 beats/min and regular; respiration rate 28/min; temperature 99.6°F.
HEENT: Moist mucous membranes TMs intact and pearly gray with cone-shaped light reflex. No lymphadenopathy.
Chest: Clear to auscultation anterior and posterior.
Heart: Regular rate and rhythm without murmurs or gallops.
Abdomen: Active bowel sounds in all quadrants. Pain to palpation RLQ and LLQ.
Skin: Dry patches to torso.
DISCUSSION:
What would be on your initial differential diagnosis list? What diagnostic tests would you order (if any)?
Discuss any follow up tests, medications, surgeries, etc.
How would you handle discussion with parents?