Case presentation A 14-year-old boy, with autism spectrum disorder, presented with a 1-day history of colicky abdominal pain, non-bilious vomiting, anorexia and loose normal-coloured stool. Two days previously, he had a poorly reheated takeaway chicken.
On examination, body mass index (BMI) was >99th centile. He had inconsistent epigastric, periumbilical and umbilical tenderness, and guarding, with normal bowel sounds. Observations were within normal limits, but his pain was poorly responsive to paracetamol, ibuprofen, hyoscine butylbromide, codeine and morphine.
What is the diagnosis?
Which serology would have been most helpful at presentation?
Amylase and lipase.
What are the acute treatment principles?
What is the the most common cause?
Questions Answers can be found on page 2.
- adolescent health
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Contributors NC wrote the article; PJ reviewed the images and provided the captions; and JH, CMc and CMo reviewed and provided comments on all versions of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests NC is funded as a clinical research fellow by Crohn’s and Colitis UK.
Provenance and peer review Not commissioned; internally peer reviewed.