Clinical History.—A 12-year-old girl was admitted to the hospital with a 24-hour history of nausea, vomiting, and periumbilical pain. These symptoms appeared about an hour after she had participated in a "stretching" game, which involved hyperextension of the spine. She could partially relieve the pain by assuming a fetal position and rocking back and forth.
Physical Examination.—There were no relevant findings on physical examination other than diffuse abdominal and rectal tenderness. No mass was palpable. Roentgenograms of the chest and abdomen were interpreted as normal. The leukocytes numbered 8,350/cu mm, with a normal differential cell count. The temperature was 36.9 C. Pain, nausea, and vomiting having subsided by the third day, the parents took the child home, saying "she was emotional."
The patient was readmitted the following day with recurrence of the same symptoms of pain, nausea, and vomiting. She now stated that the intermittent, severe pain was
Gwinn JL, Lee FA, Underberg JT. Radiological Case of the Month. Am J Dis Child. 1973;126(4):495-496. doi:10.1001/archpedi.1973.02110190407010