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A previously well 9-month-old girl attended the emergency department following episodes of profound pallor, inconsolable crying and drawing her legs up. She had no vomiting, change in stooling or fever. She was born at term with no neonatal complications. On examination, her vital signs were stable, and her abdomen was soft. Blood tests including inflammatory markers were unremarkable.
Test your knowledge
Which diagnosis is most likely?
Strangulated inguinal hernia
Which investigation would you like to perform?
CT of the abdomen
Following normal investigations, the baby was discharged with safety netting advice. She returned 1 week later with ongoing symptoms. A chest X-ray was performed (figure 1).
What finding is …
Contributors IK and MM wrote the submission, which was reviewed, edited and agreed upon by RLC and ACD.
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 None declared.
Provenance and peer review Not commissioned; externally peer reviewed.