Abdominal Pain and Anemia in a Child

Allison King, MD, MPH and John DiPersio, MD, PhD

Washington University School of Medicine, St. Louis, MO

This case was reviewed and updated in 2009 by Dr. Eric Kraut and members of the Teaching Cases Subcommittee.

Copyright of the American Society of Hematology, 2006. ISSN: 1931-6860.

II. PHYSICAL EXAM

Height 100 cm (25th percentile on growth chart)
Weight 15 kg (25th percentile on growth chart)
Temperature: 38.9ºC
Heart Rate: 135
Respiratory Rate: 40
Blood Pressure 100/60 mmHg
Oxygen Saturation Level: 87% (normal range: 92%-98%)

HEENT: Normocephalic, pupils reactive, tympanic membranes clear, oropharynx clear
Neck: No adenopathy
Chest: Mild subcostal retractions. Audible rales at lung bases.
Heart: Tachycardic with III/VI murmur
Abdomen: Mild distension, diffusely tender to palpation
Genitourinary: Circumcised male, no priapism
Extremities: Warm
Neurologic: Crying, alert boy. Face was symmetric. Moved all extremities.
Skin: No ulcers on the extremities.

What additional physical findings might occur in patients with sickle cell disease? Select all that apply.

Frontal bossing
Jaundice
Joint swelling
Splenomegaly


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