ALBERT C.YANMDSAMIR S.SHAHMD
A 7-year-old girl presented with 6 days of vomiting and abdominal pain in addition to a 3.5-kg weight loss over the past 6 months. On examination, she was pale and thin. Her weight was 16.9 kg (<5th percentile for age), and her height was 116 cm (10th percentile). Abdominal examination revealed a well-defined, firm, mobile, nontender, and nonpulsatile 8 × 8-cm mass in the left upper quadrant extending into the epigastric region. Laboratory studies showed a microcytic anemia with a hemoglobin concentration of 9.0 g/dL; the hematocrit was 26.8%. Amylase and lipase levels were normal. Hemoccult test results for stool and emesis were positive for blood. Abdominal radiography was performed (see Figure 1 and Figure 2).
Upright radiograph of the abdomen.
Kidneys, ureters, and bladder (KUB) radiograph.
What is your diagnosis?
Moffett KS, Welch JE. Picture of the Month—Quiz Case. Arch Pediatr Adolesc Med. 2006;160(5):499. doi:10.1001/archpedi.160.5.499