What The Heck? Pediatric Abdomen

Here’s an interesting case for you to think about. A three year old female is brought to your ED with a three day history of abdominal pain which has been getting worse. She started vomiting yesterday, and hasn’t wanted to eat for two days. The child has been completely healthy until now. The parents deny any history of trauma.

On exam, the child appears to be ill. She has a distended abdomen bordering on rigidity, and is markedly tender. A FAST exam is performed, which shows a small amount of fluid only in the pelvis.

Here are my questions for you:

What tests would you like to order?

What is going on here?

Remember, this is the Trauma Professional’s Blog, after all!