A pediatric Case- what is your opinion | Figure 1

%27%3e%3cg%20id=%27Group-14%27%20transform=%27translate(13.000000,%20103.176124)%27%3e%3cg%20id=%27Group-Copy-5%27%20transform=%27translate(0.000000,%20182.676124)%27%3e%3crect%20id=%27Rectangle-8%27%20fill=%27%23E2E0DE%27%20x=%270%27%20y=%270%27%20width=%2736%27%20height=%2736%27%20rx=%2718%27%3e%3c/rect%3e%3cpath%20d=%27M28,27.6503435%20C28,22.127496%2023.5228474,17.6503435%2018,17.6503435%20C12.4771525,17.6503435%208,22.127496%208,27.6503435%20M18,16.3472505%20C20.8165136,16.3472505%2023.099749,14.0640151%2023.099749,11.2475015%20C23.099749,8.43098783%2020.8165136,6.1477524%2018,6.1477524%20C15.1834863,6.1477524%2012.9002509,8.43098783%2012.9002509,11.2475015%20C12.9002509,14.0640151%2015.1834863,16.3472505%2018,16.3472505%20Z%27%20id=%27Combined-Shape%27%20fill=%27%23FFFFFF%27%20fill-rule=%27nonzero%27%3e%3c/path%3e%3c/g%3e%3c/g%3e%3c/g%3e%3c/g%3e%3c/svg%3e)

Deleted account

Some actions are only available when you log in.

Clinical scenario

A pediatric patient under four years of age, normal height and weight for age, no known medical history, presents with acute abdominal pain and complaints (by mother) having severe constipation (not moving bowels in over a week). Mother stated that he has always had trouble moving his bowels, and has been going back and forth to the doctor with the same problem, complaint only being told to change his food and given suppository but no definitive diagnosis! On exam, normal appearing pediatric male in obvious discomfort not being able to sit on buttock due to severe constipation; BS active, abdomen soft but noticeably tender to palpation. Several hard firm knotted stool removed manually from anus, but impaction remains and referred to the Emergency room for further management including deimpaction and further care!

What is the most likely diagnosis?

Cases to consider

2 year old presents to ER with complaints of cold-like symptoms and throat pain per mother. Child was in no distress, unlabored respirations, and clear breath sounds. Halfway into ER visit, mother states pt could have possibly ingested a foreign body the day prior. X-rays were ordered and pt was transferred to local pediatric facility.

9 year old African American male presents with mother, mother stated that the pediatrician sent him to our office for "Blue Nails" of which she stated the pediatrician called it. Patient is in good physical health and blood work up was ordered through his pediatric doctor. Upon exam, nail beds didn't have a "blue nail" more grayish instead. Mother stated it started a month ago. Normal capillary refills, no pain and or tenderness. Anyone have a Derm experience with this!? Suggestions for DX and treatment is appreciated. Thanks.

17 y.o. female presented to the ER with severe abdominal pain and chronic constipation. Pt. said that she is always (repeatedly) constipated and can't have a bowel movement. X-ray showed mild to medium blockage. Treated with an enema. Any thoughts as to why this is happening?

35 years old patient with constipation for 10 days but pass little gas. The patient has patent it his abdomen that made him move it Can me and resolved at the time that he was in emergency department. I sent him to erect abdominal x-ray. It did not show fluid air levels in the bowel, but the larger bowel was larger than normal. What is your management?

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this EKG that would warrant further work-up or is this just a pediatric EKG?