Open AccessVomiting of unclear etiology in an autistic child—multiple possible diagnoses: A case report
Author(s) -
Piazza Matthew,
Baldeo Rudolph,
Daniel Reethamma
Publication year - 2020
Publication title -
journal of the american college of emergency physicians open
Language(s) - English
Resource type - Journals
ISSN - 2688-1152
DOI - 10.1002/emp2.12097
Subject(s) - vomiting , etiology , medicine , medical diagnosis , physical examination , abdominal pain , cholecystitis , appendicitis , pediatrics , emergency department , choledochal cysts , general surgery , surgery , radiology , cyst , psychiatry , gallbladder
Abstract Appendicitis is a common complaint in the emergency department (ED) presenting with abdominal pain or vomiting and is often the foremost etiology the provider must rule out using history and physical examination. However, history and physical examination is limited in children and the developmentally delayed who are often non‐cooperative. Less commonly, choledochal cysts are found that also require management, or rarer still, multiple possible radiologic or surgical diagnoses. This case report follows a delayed child presenting with vomiting found to have a large type 1 choledochal cyst, cholecystitis, and appendicitis on advanced imaging prompting surgical management of these etiologies. This report reviews the evaluation of children with vomiting and the need for thorough evaluation with advanced imaging when appropriate.