Approach to chronic abdominal pain (pediatrics) Quiz: Ace Your Exams
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A 14-year-old girl presents to the emergency department with abdominal pain and bloody diarrhea for three days. The pain is severe and crampy in the left lower quadrant. She reports multiple bloody bowel movements and fecal urgency. The patient was diagnosed with Crohn disease at nine and has been in remission for two years. Past surgical and family history are non-contributory. Temperature is 38°C (100.4°F), pulse is 115/min, respirations are 16/min, blood pressure is 90/55 mm Hg, and oxygen saturation is 97% on room air. On physical examination, there is tenderness in the left lower quadrant of the abdomen without distension. The exam is otherwise normal. Labs are shown below. Which of the following is the best next step in management?
| Laboratory value | Result |
| Serum chemistries | |
| Hemoglobin | 8.9 g/dL |
| Hematocrit | 34 % |
| Leukocyte count | 14,100 /mm3 |
| Platelet count | 350,000/mm3 |
| C-reactive protein | 104 mg/L |
| Albumin | 2.8 g/dL |
| Fecal calprotectin | 3000 µg/g |
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