Approach to the acute abdomen (pediatrics) Quiz: Ace Your Exams
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A 3-day-old boy born at 37 weeks via normal spontaneous vaginal delivery to an otherwise healthy mother is evaluated on the obstetric floor. The patient initially tolerated breastfeeding, but over the past day has been increasingly lethargic with abdominal distension, and he began vomiting early in the morning. The patient did not pass meconium. The parent had no issues during the pregnancy. Temperature is 37°C (98.6°F), heart rate is 120/min, respiratory rate is 35 per minute, blood pressure is 65/35 mmHg, and oxygen saturation is 99% on room air. Physical exam reveals a distended and tender abdomen. Rectal exam is notable for an expulsion of gas and stool during digital rectal exam. Which of the following additional tests is needed to confirm the most likely underlying diagnosis?
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