Index of Suspicion * Case 1: Voiding difficulty in a 10-year-old * Case 2: Seizure-like activity precipitated by loud noise in a 2-year-old * Case 3: purplish-brown, shiny upper extremity lesion and stiff hand in a 9-year-old.

摘要

A 10-year-old boy presents with severe abdominal pain and urinary urgency. He denies any dysuria, hema-turia, frequency, meatal spotting, penile discharge, or incontinence. He has had no recent viral infections or fevers and he denies any history of perineal trauma. He has no significant medical or surgical past medical history. Three days earlier, he was seen at a local hospital with a 3-day history of increasing difficulty with voiding, including straining to void and incomplete bladder emptying. A bladder scan revealed a full bladder after he voided. Therefore, an 8-French catheter was placed and he was told to return in 3 days for a voiding trial.