Why Cry?

A 1 year old boy presents with intermittent crying for 1 day. There is no history of fever, vomiting, diarrhea, or urinary frequency.

He was completely healthy previously, with normal growth and development. All immunizations are up to date.

Select Relevant Investigations
Complete Blood Count

Performed

WBC: 8,000/mm3 (5,500-15,500)
Hb: 13 g/dL (10.5-13.5)
Hct (PCV): 35% (33-49)
Platelets: 288,000/mm3 (150,000-450,000)
Blood film: Normal
Ultrasound Abdomen

Performed

There is a target lesion in the right upper abdomen on transverse imaging. The lesion shows the pseudokidney sign on longitudinal imaging. No other abnormalities are detected.
Contrast CT Abdomen

Performed

The oral and intravenous contrast CT study confirms the presence of a target lesion in the right upper abdomen. No other abnormalities are detected.
Upper GI Endoscopy

Performed

You attempt to rationalize why upper GI endoscopy is indicated, and fail.

Select Relevant Management
IV Fluids
NG Tube
Air Enema
Urgent Surgery