101
98
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37.0
99/60

A 5 years old boy presents to the emergency department with diffuse abdominal pain. The child has no urinary symptoms. The pain started 42 hours ago. He has no history of fever and has had no vomiting with infrequent hard stools with occasional watery stools. Is stooling twice a week. Has no known sick contacts.

Past Medical History:

Past medical history is is significant for a history of poor fluid intake. Has had mild, episodic abdominal discomfort for several months. Immunizations are current. The child is on the 50th percentile for weight and growing well.

Family / Social History:

Family history is unremarkable. Social history is negative. 

Physical Exam:

On physical exam the patient appears well. Abdominal exam reveals palpable stool LLQ.

 

Labs:

Bloodwork:

WBC: 10.5x109/L

Platelets: 252x109/L

Hemoglobin: 141 g/L

MCV: 82 fL

C-reactive Protein: 3 mg/L

Imaging:

Abdominal Xray: Fecal loading

What is the most likely diagnosis?

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Authors

Dr. Susan Bannister

Susan.Bannister@ahs.ca

Dr. Theresa Wu

theresa.wu@ahs.ca

Reviewer

Dr. Marc Zucker

Zucker@cheo.on.ca