03-29-2016, 11:54 AM
A 2-year-old girl is brought to the emergency department because of the abrupt onset of spasms of severe, crampy abdominal pain. The mother says that she was "completely fine" earlier in the day. She picked her up from a "play date" at her friend's house, they picked up some fast food for dinner, and before she even started to eat, she became very irritable, and began complaining of pain. In the hospital bathroom, she had a bowel movement with mucus and blood. She is generally healthy and takes no medications. She is lying on the examination table with her knees drawn into her chest. Her temperature is 36.7 C (98.0 F). Physical examination shows a tender, sausage-shaped mass in the right lower quadrant. Rebound tenderness is not present. A nasogastric tube is placed. The most appropriate next step is to
A. arrange for immediate exploratory laparotomy
B. begin therapy with metronidazole
C. order a barium enema
D. order a CT scan of the abdomen
E. reassure that the condition is self-limiting and no further studies are needed
A. arrange for immediate exploratory laparotomy
B. begin therapy with metronidazole
C. order a barium enema
D. order a CT scan of the abdomen
E. reassure that the condition is self-limiting and no further studies are needed