A 4-year-old girl presented to the hospital with progressive abdominal pain and distention after a 1-week history of watery diarrhea. The physical examination showed a body temperature of 36.2°C, a distended abdomen, hypoactive bowel sounds, and diffuse tenderness without rebound pain. The laboratory evaluation revealed a white-cell count of 5000 per cubic millimeter, with 63% segmented neutrophils,
What is the diagnosis?
Perforation of a viscus
Correct Answer : Perforation of a viscus
The plain-film radiograph of the abdomen shows several signs of free intraperitoneal gas. These include air accumulation in the right upper quadrant; the falciform-ligament sign, visible as a longitudinal linear density on the ventral surface of the liver; the ligamentum teres sign, visible as a linear density running along the inferior edge of the falciform ligament; and the visualization of air on both sides of the bowel wall. The patient had a perforated cecum.
Created by USMLE PlAB MCQ
Created by USMLE PlAB MCQ
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