2 year-old male with no PMHx is brought to the ED for intermittent abdominal pain for the past two days. Mom notes that the child will crouch down into a ball when he has pain, which only lasts for a few minutes at a time. He has decreased solid food intake but no vomiting or diarrhea and is otherwise well. Vitals and physical exam are unremarkable. The ultrasound is shown below…what’s the diagnosis?
Lauren Murphy, MD
A 42 year-old female presents with HTN, DM, and obesity 4 days of abdominal pain. The pain is worsened by eating and associated with nausea; her vitals are within normal limits and she is afebrile. What's the diagnosis?
Answer: False. Infants present with non-bilious vomiting
Diagnosis: Pyloric Stenosis
Pathology: Pyloric stenosis is hypertrophy and hyperplasia of the pylorus with a multifactorial inheritance in families. The incidence is 5/1000 births in males and 2/1000 births in females. It is therefore more common in males; it is also more common in first-born infants, and in Caucasian infants.
Case: A six week-old previously healthy, term infant via vaginal birth is brought to pediatric ED for repeated episodes of vomiting over a one week period. Vomiting occurs 20-30 min following every episode of feeding and is described as projectile. Parents note decreased urine output over the past two days. Patient is noted to be hungry following vomiting episodes
Case: A 2 year-old male with no significant PMH is brought to the Emergency Department by his mother for intermittent abdominal pain for the past two days. Mom notes that the child will crouch down into a ball when he has pain, which lasts only a few minutes at a time. He has decreased solid food intake but no vomiting or diarrhea and is otherwise well.
Case: A 74 yo male patient with a PMH significant for rectal carcincoma (s/p chemotherapy and radiation; refused surgery) arrives with chief complaint of rectal pain and general malaise for two week duration. He notes urinary and fecal incontinence over this same time period. He also notes intermittent fevers.
Case: A 42 year old female patient with a past medical history significant for diabetes, obesity and hypertension presents to the ED with chief complaint of 4 days of abdominal pain.
Case: 55 year old female with unknown medical history presents to the Emergency Department by EMS after having a seizure. Prior to the seizure the patient was found "acting strangely" and agitated outside on her street. Patient had a witnessed seizure after police arrived.