Approach to constipation (pediatrics) Quiz: Ace Your Exams
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A 5-day-old girl is brought to the pediatrician for a weight check. The patient was born at 37.5 weeks gestation by uncomplicated vaginal delivery. The mother did not know she was pregnant until she was 14 weeks gestation, and she did not receive adequate prenatal care. The patient passed meconium on day one of life but has not stooled since. Parents report she is bottle feeding well with good urine output. Vital signs are within normal limits. The patient is down 5% from birth weight. Physical examination demonstrates a well-appearing neonate in no acute distress. There is a small tuft of hair above the gluteal cleft as seen in the image below. Abdomen is soft, nontender, nondistended, with normoactive bowel sounds. Rectal examination does not demonstrate evidence of imperforate anus but does show a diminished anal wink reflex. The patient is moving all extremities but has decreased tone in the lower extremities. Which of the following tests should be performed next?
Reproduced from: Wikipedia
Reproduced from: Wikipedia
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