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Vomiting and Dehydration in a 2-Year-Old

Katherine Edmunds1, Juan Gurria2, George Koberlein3,4

  • 1Divisions of Emergency Medicine and katherine.edmunds@cchmc.org.

Pediatrics
|February 14, 2019
PubMed

Insights

A pediatric case highlights unusual symptoms including vomiting and bradycardia in a 2-year-old. Imaging revealed findings concerning for appendicitis, leading to surgical intervention.

Area of Science:

  • Pediatric Surgery
  • Emergency Medicine
  • Gastroenterology

Background:

  • A 2-year-old girl with a history of cutaneous mastocytosis and eczema presented with acute symptoms.
  • Initial presentation included vomiting, bradycardia, and listlessness, prompting evaluation for dehydration.

Observation:

  • Despite fluid rehydration, the patient exhibited persistent bradycardia and decreased energy.
  • Diagnostic workup included electrocardiogram, laboratory tests, abdominal radiography, and computed tomography scan of the head.
  • Abdominal ultrasound revealed a blind-ending tubular structure with free fluid, raising suspicion for appendicitis.

Findings:

  • Sinus bradycardia was noted on electrocardiogram.
  • Laboratory results and glucose levels were within normal limits.
  • Abdominal imaging suggested appendicitis, prompting surgical consultation.

Implications:

  • This case underscores the importance of considering appendicitis in pediatric patients presenting with atypical symptoms.
  • Early and accurate diagnosis through imaging is crucial for timely surgical management.
  • Understanding the differential diagnosis in pediatric emergencies is vital for effective patient care.

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