after meals or visits with his cousins. She denies nausea, vomiting, rash, or change in urine output. There is no history of trauma, fever, or environmental exposures.
In the ED, T 37.8 HR 122 BP 126/70 RR 24 SpO2 99% RA. The boy is active and well appearing considering his mother’s recounting. His head and neck, cardiopulmonary, neurologic, and skin examinations are normal. The boy’s abdomen is full and slightly distended. He has a non-tender mass that extends midway from his left anterior costal line to his symphysis pubis. His genitourinary examination is normal.
Which of the following is the MOST likely diagnosis?
B. Wilms’ tumor
C. Stercoral concretion
D. Lead poisoning
In the meantime, a quote –
"Never, no never does Nature say one thing and wisdom another."
– Johann Christoph Friedrich von Schiller (1759 – 1805), German philosopher and