Sneha Celine Jossie, Mahima Gajanan Kamath, Nitin Verma
The Journal of Pediatric Academy - 2025;6(4):167-169
This study aims to highlight the diagnostic challenges of acute abdominal presentations in children with overlapping infectious and obstructive features. A 7-year-old girl with recent travel history presented with vomiting, diarrhea, and reduced urine output. Examination revealed dehydration and epigastric tenderness. Laboratory investigations showed elevated inflammatory markers, with positive stool PCR for enteroaggregative Escherichia coli (E. coli), enteropathogenic E. coli, and norovirus. Red flag features, including bilious vomiting and absent bowel sounds, prompted further evaluation. Imaging demonstrated inflammatory changes in the right iliac fossa with partial bowel obstruction. The patient was managed with supportive care and nasogastric decompression, leading to gradual clinical improvement. She was discharged in stable condition and subsequently demonstrated full recovery with appropriate weight gain at follow-up. This case emphasizes the importance of considering mechanical obstruction. In pediatric patients presenting with presumed infectious gastroenteritis, particularly when red flag features are present, further evaluation is recommended. Early recognition and timely intervention can prevent complications and improve outcomes.
