Regarding Dr. Barreira's case of the 12 year old with high fever
(39.5C-40.0C), vomiting and abdominal cramps two days ago:
I would be concerned about : (1) Meckel's diverticulum (2) Intussusception (3)
acute clinical manifestation of inflammatory bowel disease.
What did the obstructive series show? I had a case like this recently (but
with less blood in stool) and the child had free air. He went to CT to help
the surgeons decide whether to go after a perforated appy versus perforated
bowel from ???
At laparotomy, he had a perforated Meckel's diverticulum.
I would (1) start antibiotics (2) get an obstructive series (3) technetium
scan. If obstructive series revealed AF levels or possible obstruction - then
Air contrast barium enema would be needed immediately.
I look forward to follow-up on this case.
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