Description

GH is a 26 month old male patient with a past history of Down Syndrome who presents to clinic with mother who reports abdominal pain for the past two days. The mom stated pt fell off bed while at home with her boy friend. She states that the pt has been whining and refusing to eat and has a noticeable bruise to his abdomen. Physical examination revealed hypotension, tachycardia, tachypnea, hypoactive bowel sounds. He also has a faint circumferential macular discoloration at wrists consistent with aging ligature marks. Physical examination also revealed a firm distended abdomen with ecchymoses overlying the epigastrium area. Pertinent negatives include adventitious breath sounds and head trauma.