[Skip to Navigation]
January 1993

Radiological Cases of the Month

Author Affiliations

From the Department of Radiological Sciences, University of California, Irvine Medical Center (Dr Jacobs); Department of Pediatric Surgery, Childrens Hospital Los Angeles (Calif) (Dr Ishitani); and Department of Radiology, Childrens Hospital of San Diego (Calif) (Dr Senac).

Am J Dis Child. 1993;147(1):69-70. doi:10.1001/archpedi.1993.02160250071021

A 9-year-old boy was admitted with a 3-day history of increasingly severe, left-upper-quadrant abdominal pain, anorexia, nausea, vomiting, and constipation. He was previously healthy, but 1 week before admission had fallen from an ice-cream truck and had experienced 2 days of similar, though less severe, symptoms. At a local emergency department, frontal abdominal roentgenograms had been obtained (Figs 1 and 2). He was diagnosed as having constipation and was discharged.

On admission, the child was in obvious discomfort. His temperature was 38.4°C. Pulse and blood pressure were normal. The bowel sounds were diminished. He was splinting to the left, and there was marked left-upper-quadrant tenderness, rebound tenderness, and guarding. The hematocrit level was 0.43, and the white blood cell count, 18.3×109/L. Levels of serum amylase and lactate dehydrogenase were normal. Computed tomography of the abdomen was performed to evaluate possible splenic injury.

Denouement and Discussion 

Bochdalek Hernia After 

Add or change institution