A rare cause of abdominal pain in children
Haarman, M.G.; Janssen, D.J.M.T.; van der Wal, M.A.; Kenter, S.
Nederlands Tijdschrift Voor Geneeskunde 160: A9597
2016
ISSN/ISBN: 1876-8784 PMID: 27229690 Document Number: 687251
A 4-year-old boy was admitted to our hospital with abdominal pain, vomiting and weight loss. After a period of diarrhoea, he was now constipated. Micturition was painful but there were no abnormalities in the urine. Blood test showed no signs of infection or elevated liver enzymes. Signs of cholecystitis were seen on abdominal ultrasound, but this diagnosis was ignored because of the low incidence of cholecystitis in children and the absence of abnormal liver enzymes and infection parameters. Other diagnostic investigations were carried out, but no cause could be found for his symptoms. His condition worsened during the hospital stay, and liver enzymes and infection parameters became abnormal. An abdominal laparoscopy was finally performed, and a perforation in the presence of a necrotizing cholecystitis was seen. This case shows that one should never ignore a diagnostic report even if the diagnosis has low prevalence.