Case 25-1999

Presentation of Case A 16-year-old boy presented to the hospital as an outpatient because of recurrent abdominal pain. The patient had been well until the age of four years, when he began to have two or three bouts annually of mild, crampy abdominal pain that lasted from a few hours to a day and were occasionally accompanied by fever. At the age of 14 years, he had a more severe bout of pain, followed by several days of profuse vomiting and dehydration. He was admitted to another hospital, where abdominal radiographs showed dilated loops of small bowel with air–fluid levels. . . .