What's the Diagnosis? By Dr. Jared Klein
A 3 month old male with a history of ileostomy s/p revision, left inguinal hernia s/p repair, and incisional hernia presents to the ED with abdominal distension and vomiting. He is febrile and irritable. A plain abdominal xray is shown below. What's the diagnosis? Scroll down for answer.
Answer: Perforated viscus
- X-ray shows intraperitoneal free air - this case demonstrates the the importance of 2 views as free air notable tracking on the right side of abdomen with left side is down
- Management involves stat surgical consultation, broad spectrum antibiotics including anaerobic coverage, and fluid resuscitation