Question of the Week

Question :
Posted On : 25 Jun 2023
A 3-year-old patient with intermittent pain abdomen, colicky in nature, history of constipation present, Pper examination normal, PR examination revealed empty bowel. USG and xray abdomen normal. CBC revealed Microcytic HC anemia.
The patient was admitted in v, o persistent pain, and started on IVF, antispasmodics, and lactulose. Severe pain abdomen is persisting and the child passed a small amount of stool after Lactulose and bisacodyl. What are diagnostic possibilities and What management is to be done?
Expert Answer :
It could be a case of lead poisoning. The serum lead level will be a useful investigation at this stage.
Answer Discussion :
lusungu muchelenganga
On the list of my differentials i would consider
1.Chronic Lead poisoning
2.Worm infestation
So i guess further tests would help clench the diagnosis like stool samples for microscopy,culture and occult blood,urine for culture and sensitivity, peripheral smears,Bone marrow aspirates,serum lead levels,Colon biopsies.
Basically this child has a probable iron deficiency anemia whose cause must be found and adequately treated in addition to iron supplementation.

11 months ago
Arunika Prakash
celiac disease, meckel diverticulitis, toddler diarrhoea, uti
11 months ago
Jonathan byam
ddx: hirchsprung disease, common in that age group
warm infestation in view of the microcytic picture.

Do stool analysis for the patient

11 months ago

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