Presentation
Septic child, grossly distended abdomen. Evidence of perforation?
Patient Data
Abdomen
Grossly distended stomach measuring 25 cm occupying the left side of the abdomen. Slightly mottled appearance within the stomach. Resultant small bowel dilatation and displacement into the right side of the abdomen.
Chest
Endotracheal tube at the carina. Suggest retraction. NG tube tip projected over the cardia of the stomach.
Lungs clear. No pneumoperitoneum.
Case Discussion
Grossly distended stomach in a child. This combined with the mottled appearance in the dependant part of the distal stomach raises the suspicion of a bezoar. Clinical history is always very important in these cases even if retrospective.
Subsequent additional investigations in a tertiary hospital confirmed a bezoar.
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