Approach to melena and hematemesis (pediatrics) Quiz: Ace Your Exams
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A 2-year-old boy presents to the emergency department for evaluation of abdominal and chest pain for three hours and two episodes of vomiting, the most recent one with hematemesis. The parents report that he is not able to swallow solids or liquids. Parents report that the child was playing in the playroom unsupervised when these symptoms began. There is no history of similar episodes and no history of diarrhea or fever. He has no surgical history, and family history is non-contributory. Temperature is 37 °C (98.6 °F), pulse is 100/min, respirations are 25/min, blood pressure is 98/59 mm Hg, and oxygen saturation is 97% on room air. On examination, the child appears irritable, and there is mild abdominal tenderness with a soft and nondistended abdomen. Cardiopulmonary exam is unremarkable. Chest x-ray is shown below. Which of the following is the most appropriate next step in management?
Reproduced from: Wikipedia . Licensed under; CC BY 3.0
Reproduced from: Wikipedia . Licensed under; CC BY 3.0
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