Adolescent Male With Abdominal Pain

Abstract

A 15-year-old boy presented to emergency department (ED) with abdominal pain without fever for 2 days. Local peritoneal signs were found over the McBurney point. Laboratory findings showed a WBC count of 22,800/μL and c-reactive protein level of 2.06 mg/dL (normal <0.5 mg/dL). Abdominal ultrasonography failed to visualize the appendix. However, it detected multiple marblelike objects with hypoechoic rims and hyperechoic centers (Figure 1) over the epigastrium. Abdominal computed tomography (CT) showed an engorged appendix, which confirmed the diagnosis of acute appendicitis.