A 7 years old girl presents to the emergency department with diffuse abdominal pain. The child has no urinary symptoms. The pain started 8 hours ago. She has no history of fever and has had no vomiting with infrequent 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 delayed. 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 stools and anal fissures.

Labs:

Bloodwork:

WBC: 9.8x109/L

Platelets: 327x109/L

Hemoglobin: 147 g/L

MCV: 84 fL

C-reactive Protein: 8 mg/L

Imaging:

Abdominal Xray: Normal