A 5-yr-old boy was admitted with a complaint of severe abdominal pain of three days' duration that had spontaneously occurred without a noticeable cause. At the time of admission, he had no other symptoms than abdominal pain and vomiting. His initial body temperature was checked at 38℃ with a slight fever that could be noticed until admission, with a pulse rate of 124 beats per minute and respiration at the rate of 30 per minute. On physical examination, he appeared acutely ill. There was no specific lesion in the oral cavity or on the tongue.
Neither erythema nor swelling on both extremities was found. His abdomen was soft and moderately distended with decreased bowel sound. Direct tenderness was so diffuse and severe, especially on the lower abdomen, that it was difficult to differentiate from the surgical abdomen. Rebound tenderness was obvious without muscle guarding.…
