give me a differential for this...

[dave262]

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So I cant figure this case out.

7 y/o girl presents with 2 day history of 8/10 diffuse epigastric pain and bilious vomit, better after vomiting worse with food. Two admissions in the past 4 months for the same problems which resolved spontaneously. Labs have consistently showed thrombocytosis, elevated eosinophils, elevated calcium, and elevated indirect bili. No other abnormal labs. Abd CT was unrevealing, US showed mildly dilated gallbladder, no other hepatic, renal or other abnormality. Never febrile.

I'm thinking partial SBO maybe parasites?

 

[retroviridae]

So I cant figure this case out.

7 y/o girl presents with 2 day history of 8/10 diffuse epigastric pain and bilious vomit, better after vomiting worse with food. Two admissions in the past 4 months for the same problems which resolved spontaneously. Labs have consistently showed thrombocytosis, elevated eosinophils, elevated calcium, and elevated indirect bili. No other abnormal labs. Abd CT was unrevealing, US showed mildly dilated gallbladder, no other hepatic, renal or other abnormality. Never febrile.

I'm thinking partial SBO maybe parasites?

shouldn't this be in the pedi forum?

 

[AJM]

shouldn't this be in the pedi forum?

Aren't kids just little adults anyway? 😉 😛

Moving to the peds forum....

 

[dave262]

So I cant figure this case out.

7 y/o girl presents with 2 day history of 8/10 diffuse epigastric pain and bilious vomit, better after vomiting worse with food. Two admissions in the past 4 months for the same problems which resolved spontaneously. Labs have consistently showed thrombocytosis, elevated eosinophils, elevated calcium, and elevated indirect bili. No other abnormal labs. Abd CT was unrevealing, US showed mildly dilated gallbladder, no other hepatic, renal or other abnormality. Never febrile.

I'm thinking partial SBO maybe parasites?

So we've diagnosed her with primary motility disorder and sent home on bethanachol.