We received a 6 year old female with a 2 day history of crampy abdominal pain. The pain is located in the upper mid-abdomen and is associated with anorexia, nausea and four episodes of green vomitus. She appears to be weak and her parents noticed a decrease in urination. There is no history of diarrhea, trauma, fever or coughing. She has not passed any stools for the two days that she has been ill. Her past history is significant for an appendectomy one year ago. Her family history is negative for other family members with similar problems.
On examination VS T 37.0, P110, R 12, BP 100/60. She is alert and subdued. Also WBC 14.0, Hgb 16, Hct 48, Na 132, K 3.0, Cl 90, bicarb 30. Urinalysis: SG 1.030, no pyuria or hematuria. Kindly give your advice on differential diagnosis. What tests can be carried out further?
