Our Imaging Case of the Month is presented as a part of the Imaging Department's residency teaching program. Each month a resident collaborates with one of our attending imaging physicians to present an interesting case to the Cedars-Sinai medical community. The case is used to teach both imaging and other residents at Cedars-Sinai. Below is the current Case of the Month.
Submitted by Catherine Evans, MD, and Thomas J. Learch, MD
A 10 year-old girl with no significant past medical history presented as a transfer from OSH with 4 day history of severe lower abdominal pain, nausea and vomiting. Patient reported associated symptoms of dysuria, red-tinged hematuriax 3 days and diarrhea x 2 days. Mother at bedside also reported subjective fevers and decreased appetite. Patient had not begun menstruation. Of note, patient’s mother began menstruation at age 11.
- General: Ill-appearing, Diaphoretic.
- HEENT: Anicteric, Normocephalic.
- Cardiovascular: Tachycardic, No murmur.
- Chest: Respirations are non-labored, Symmetric.
- Abdomen: Soft, Non-distended. Diffusely tender, worst suprapubic/bilateral lower quadrants.
- GU - Female: Normal external genitalia.
- Extremities: Warm, Well perfused, Moves all extremities.
- Neurologic: No focal neurological deficit observed, Developmentally normal.
- WBC 21.6
- T bili 1.6
- AST/ALT 69/84
- Temperature 37.8 C
- Respiratory rate 28 breaths/min
- Heart rate 130 bpm
- Blood pressure 119/77
Abdominal ultrasound and contrast-enhanced CT abdomen/pelvis was performed at the outside hospital. What are the findings?
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