Abdominal pain in 3 year old male

3 year old male presented with the complaint of abdominal pain, anorexia and vomiting. Cinically suspected for appendicitis. What is your opinion?

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Abdominal pain in a 3 year old child with anorexia,and vomiting can be 1.Acute intussuseption 2.Acute appendicitis 3.Acute viral hepatitis 4.Acute non - Specific mesentric lymphadenitis. Clinical examination is most important like 1.In Appendicitis- Rebound tenderness at Mcburny's point and some part of lower abdomen 2.Shifting tenderness in non - Specific mesentric lymphadenitis 3.Empty right iliac fossa,( Dance sign ) - blood in stools- red currant jelly in Acute intussuseption. Ultrasonography is indicated for further evaluation

multiple air fluid levels in the xray . probably sub acute intestinal obstruction . do usg to confirm . make a habit to present the case properly . abdominal pain was located where . vomiting bilious or non bilious . fever present or not .

Apparently seems to be case of obstructive features and likely causes may be A. Acute appendicitis may fulminating infection or perforating following a gangrenous change leading to peritonitis and paralytic ileus B intussuseption Needs more clinical evaluation , first by clinical examination and imaging In case of appendix tenderness of rt iliac fossa and associated guarding of peritoneum , rebound tenderness bowel sound may sound may be sluggish. USG may give the correct idea as bull' s eye in case of intussuseption In case of appendicitis there may be signs with dilated bowels

Thanks Dr Bipin Bihari Jain.
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? INTESTINAL OBSTRUCTION.. NEED'S.. USG..STUDY.. CTCE STUDY ABDOMEN.. SURGEONS OPINION..

Tnx Dr Ramesh C Yadav
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Possibly obstructive etiology. Adv USG abd and pelvis, Sos CT abdomen. If acute onset treatment conservatively. See for electrolytes correction.

?intestinal intessusption descending colon is dialated

Edited Try ba enema
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Obstructive pathology involved. Ac.Appedicitis ?. Advice for Barium meal study up to I.& S..

Megacolon Appendicitis is clinical diagnosis Ct abdomen pelvis with contrast Opinion of paediatric Gastroenterologist

Apparently obstruction Laparotomy after CT scan

Thanks Dr. Pooja Laharia, Dr. Sandeep Ghodeker, Dr. Dinesh Gupta, Dr. Mrinal Kantil Pal, Dr. Shivraj Agrawal
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SUGGESTIVE. OF MEGACOLON ..DISTENDED... ADVISABLE ..U. S. G

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