title: Point-of-care ultrasound in a patient with perforated appendicitis.
abstract: We present the case of an 8-year-old girl with two emergency department visits for constipation and abdominal pain. Her medical history and physical examination noted by the emergency physician did not reveal a clear etiology of her symptoms until the second visit, when a point-of-care ultrasound was performed. The sonographic findings were consistent with a fecalith surrounded by fluid concerning for appendiceal rupture. A computerized tomographic scan of the abdomen confirmed these findings in addition to two large abscesses in the lower pelvis, which subsequently required percutaneous drainage. This case illustrates the utility of point-of-care ultrasound in the evaluation of the pediatric patient with abdominal pain when appendicitis is a concern, as well as the ability of the emergency physician to use this technology to guide treatment and care of pediatric patients.
authors.affiliation: From the *Department of Emergency Medicine, St Luke's-Roosevelt Hospital Center, New York, NY and †Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Elyse Katz
authors.initials: EK
authors.lastname: Lavine
authors.forename: Turandot
authors.initials: T
authors.lastname: Saul
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Frasure
authors.forename: Resa E
authors.initials: RE
authors.lastname: Lewiss
mesh_terms: D018784:Abdominal Abscess / Q000000981:diagnostic imaging / Q000209:etiology; D015746:Abdominal Pain / Q000209:etiology*; D001064:Appendicitis / Q000150:complications / Q000000981:diagnostic imaging*; D001065:Appendix / Q000000981:diagnostic imaging*; D002648:Child; D003248:Constipation / Q000209:etiology; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D019095:Point-of-Care Systems; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging; D014463:Ultrasonography