A 13-Year-Old Boy With a 3-Month History of Malaise

Dafina B. Kuzmanovska, MD, PhD

Disclosures

April 30, 2015

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Background

A 13-year-old boy presents to the emergency department with a history of epigastric pain, vomiting, malaise, polyuria, and a 12-lb weight loss during the past 3 months. The parents have brought him to the emergency department today because his pain and vomiting are worsening. They report no history of hematuria, hematemesis, fever, chills, or any other associated symptoms; prior surgeries; or medical problems.

The patient was previously seen by his pediatrician and is undergoing a work-up. Upper gastroendoscopy performed at a nearby hospital 2 weeks ago had revealed chronic gastritis with erosive changes in the antral region. Triple treatment for Helicobacter pylori, however, did not lead to any improvement. Abdominal ultrasonography also performed at that time showed mild nephrocalcinosis.

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