Clinical Practice and Cases in Emergency Medicine
A Young Boy with Fever and Grunting
- Author(s): Shapiro, Daniel J.
- Neal, Jeffrey T.
- et al.
Published Web Locationhttps://doi.org/10.5811/cpcem.2020.11.49721
Case Presentation: A 16-month-old boy presented with acute fever of 99° Fahrenheit (after receiving antipyretics), grunting, and tachypnea. On examination, he was tachycardic, tachypneic, and ill-appearing with abdominal distention and diffuse tenderness. A plain film abdominal radiograph showed moderate free air, and emergent laparoscopy revealed perforated Meckel’s diverticulitis with peritonitis.
Discussion: Although tachypnea and grunting in preverbal or nonverbal patients are often considered to be signs of respiratory illness, these findings may reflect intra-abdominal emergencies. Perforated Meckel’s diverticulitis is an important differential consideration in patients with pneumoperitoneum.