by Jamie Martin, Children’s National
with Shilpa Patel, Children’s National

The Case
The case is a 12 year old male with abdominal pain and vomiting for 1 day who is visiting from Korea. The challenge of the case is deciding how to appropriately address his abdominal tenderness.

Here’s How You Answered Our Questions

Denouement
Radiology was called and asked to comment on the appendix given the abdominal exam.  The radiology attending viewed the images and asked to send the patient back for additional images of the RLQ and RUQ.  A secondary prelim US reading demonstrated intussusception, seen in the central pelvis extending into the RLQ with RLQ bowel wall thickening.  Surgery  was consulted and a CT abdomen was performed. The patient was ultimately taken to the OR.

Final diagnosis: Ileo-ileal intussusception, 15 cm. Meckel’s diverticulum.