Approach to acute abdominal pain (pediatrics) Quiz: Ace Your Exams
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A 4-year-old boy is brought to the Emergency Department by his parents for evaluation of 1 day of progressively worsening abdominal pain. The parents report that he has had mild intermittent abdominal pain over the last month, but today the pain is worse than in the past month. It is now limiting his activity. The patient has had a noticeable decrease in appetite over the past 24 hours but. He has been drinking well with good urine output. There is no change in urinary frequency or urine appearance. He stools 1-2 times per week and occasionally the stools are hard pellets. Weight is at the 48th percentile and height is at the 57th percentile. Temperature is 37.1°C (98.8°F), pulse is 118/min, blood pressure is 93/50 mm Hg, respirations are 24/min, and oxygen saturation is 100% on room air. On physical examination, the patient appears uncomfortable. The abdomen is mildly distended with normoactive bowel sounds. There is mild mid-abdominal tenderness without rigidity. A mass is palpated in the lower left quadrant of the abdomen. There is no right lower quadrant tenderness and there is no rebound, guarding, or hepatosplenomegaly. The testicles are descended with appropriate cremasteric reflex bilaterally. Which of the following is the best next step in management?
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