A previously asymptomatic 10-year-old boy was brought to the emergency room with complaints of intense, diffuse abdominal pain, which developed suddenly while he was playing soccer. There was no history of trauma or previous episodes of abdominal pain. On physical examination, he appeared malnourished, with slight pallor and signs of significant discomfort. He was afebrile, with a heart rate of 124 beats per minute, a blood pressure of 140/100 mm Hg, and shallow breathing. The abdomen was diffusely tender and slightly distended. Results of a rectal examination were normal. Upright abdominal roentgenograms in anteroposterior and lateral projections were obtained (Fig 1).
Denouement and Discussion
Perforated Gastric Ulcer in a Rock EaterAdditional history revealed that the child
Garcia C, Schulbe K, Markowitz RI, Young LW. Radiological Case of the Month. Am J Dis Child. 1987;141(2):213-214. doi:10.1001/archpedi.1987.04460020103039