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Article
April 1995

Radiological Case of the Month

Author Affiliations

From the Department of Pediatrics (Drs Murray and Hough) and Radiology (Dr Ryan), Children's Hospital and Medical Center, Seattle, Wash. Dr Murray is currently with the Department of Gastroenterology and Nutrition, Children's Hospital, Boston, Mass.

Arch Pediatr Adolesc Med. 1995;149(4):460-461. doi:10.1001/archpedi.1995.02170160114018
Abstract

A3 ½-YEAR-OLD BOY presented with a 2-day history of abdominal pain, anorexia, and nonproductive vomiting. There was no history of trauma or previous abdominal surgery. He had previously received a diagnosis of fragile X syndrome.

Examination revealed moderate distension of the abdomen, diminished bowel sounds, and minimal epigastric tenderness. No guarding or rebound tenderness was elicited. A nontender mass was palpated in the right lower quadrant of the abdomen.

Laboratory investigation revealed an elevated leukocyte count of 17×109/L, serum amylase level of 426 U/L (normal, <103 U/L), serum lipase level of more than 90 U/L (normal, <90 U/L), and serum glucose level of 9.2 mmol/L (166 mg/dL). Results of liver function tests and levels of serum cholesterol, triglycerides, and calcium were normal. Twenty-four hours later, his leukocyte count increased to 22×109/L, with 0.9 polymorphonuclear cells. The serum glucose level increased to 12.9 mmol/L (232 mg/dL);

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