Approach to chronic abdominal pain (pediatrics) Quiz: Ace Your Exams
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A 10-year-old girl presents to a clinic along with her parents for evaluation of abdominal pain for seven months. The pain is periumbilical and does not radiate to the back or chest. The pain occurs three days a month and is described as intense, severe in the morning, associated with nausea, and lasting for an hour. There are no identifiable triggers, and nothing alleviates her pain. She reports no pain between episodes. She has not had bloody stool, weight loss, recurrent fevers, or a skin rash. She has regular bowel movements. She has missed multiple days of school because of her symptoms. Past medical, family and surgical history are non-contributory. Temperature is 37°C (98.6°F), pulse is 92/min, respirations are 16/min, blood pressure is 115/67 mm Hg, and oxygen saturation is 97% on room air. The physical examination is normal. Complete blood count, liver function, and stool analysis are normal. Abdominal X-ray is unremarkable. Which of the following is the most likely diagnosis?
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