Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Abdominal pain with a twist | Mathews et al. International Journal of Emergency Medicine 2011 4 21 http content 4 1 21 o International Journal of Emergency Medicine a SpringerOpen Journal CASE REPORT Open Access Abdominal pain with a twist Rachael Mathews1 Sam Thenabadu1 and Thiagarajan Jaiganesh2 Abstract Malrotation in children is due to either an incomplete or non-rotation of the foetal mid-gut during perinatal development. Presentation is usually in the first few weeks of life often with life-threatening volvulus and ischaemia. However it can be a rare cause of abdominal pain in older children and young adults. We present such a case as a reminder to emergency physicians that malrotation should be considered in the differential diagnosis of recurrent or chronic abdominal pain not only in children but also in adolescents. The Case A 14-year-old boy presented to the paediatric emergency department PED with a 24-h history of intermittent right-sided abdominal pain and bilious greenish vomiting that had settled just prior to his arrival to the PED. His haemodynamic parameters were normal and clinical examination including an abdominal examination was unremarkable. His past medical history revealed that he had experienced at least four identical previous episodes of abdominal pain with vomiting that necessitated attending three different emergency departments over a 1-year period. On each occasion he had been admitted to a general paediatric or a paediatric surgical ward with provisional diagnoses of evolving appendicitis but was discharged home as his blood results including inflammatory markers and abdominal ultrasound scans were normal. He had received quadruple therapy bismuth salts amoxicillin omeprazole and metronidazole for H. pylori infection identified on stool antigen test and on hydrogen breath test almost 6 months prior to this presentation. He was awaiting an upper GI endoscopy because of his recurrent symptoms. He was admitted to the paediatric ward on this .
