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Acute chylous ascites mimicking appendicitis A 6-year-old Caucasian boy presented with his mother to the emergency department with a 1-day history of central abdominal pain that radiated to his lower abdomen. It was worse with movement and was not associated with nausea or vomiting. The patient’s past medical history included previous tonsillectomy, adenoidectomy, Henoch– Schonlein purpura with bilateral epidydimitis in 2011 and a haemangioma excised from under his left eye. Blood tests were performed, which were normal, and he was discharged home and asked to return if his symptoms worsened. He returned to the emergency department the next day with his mother with worsening abdominal pain and feeling ‘hot’ overnight. On examination, the patient was a lean, healthy-looking boy who appeared comfortable and well. He had a heart rate of 92, respiratory rate of 20 with an oxygen saturation of 100% and temperature of 36.5. His abdominal examination revealed a soft abdomen with tenderness mainly in the right and left iliac fossa. There was some voluntary guarding and percussion tenderness. His testes and scrotum were normal. Blood tests were normal with a white cell count of 10 and C-reactive protein of
Acute chylous ascites mimicking appendicitis A 6-year-old Caucasian boy presented with his mother to the emergency department with a 1-day history of central abdominal pain that radiated to his lower abdomen. It was worse with movement and was not associated with nausea or vomiting. The patient’s past medical history included previous tonsillectomy, adenoidectomy, Henoch– Schonlein purpura with bilateral epidydimitis in 2011 and a haemangioma excised from under his left eye. Blood tests were performed, which were normal, and he was discharged home and asked to return if his symptoms worsened. He returned to the emergency department the next day with his mother with worsening abdominal pain and feeling ‘hot’ overnight. On examination, the patient was a lean, healthy-looking boy who appeared comfortable and well. He had a heart rate of 92, respiratory rate of 20 with an oxygen saturation of 100% and temperature of 36.5. His abdominal examination revealed a soft abdomen with tenderness mainly in the right and left iliac fossa. There was some voluntary guarding and percussion tenderness. His testes and scrotum were normal. Blood tests were normal with a white cell count of 10 and C-reactive protein of
