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Dr. Gordon brings up a case of gastro

January 29, 2014 0 Comments

This child was ~ 5 years old. Previously well. One day history of lots of vomiting and diarrhea. Looked pretty wiped out. Nothing specific to find on exam.

POCUS revealed the maximum IVC diameter to be much less than the aortic diameter. According to some paediatric studies in normal patients the two diameters should be roughly the same. Also the IVC collapsed completely on inspiration.  Both findings point to a patient that would likely tolerate some extra fluids!

IVC_Aorta

The bladder showed some urine. You can take 3 axes at right angles: A, B & C and the bladder volume is ~ A*B*C/2. So in this child ~30-60 cc.  Regardless of measurements this image clearly shows the child is producing urine and if a catheter sample was required, there is an adequate volume present for the procedure.

Bladder_RectumIf you look “below” the bladder you will see a grossly oedematous rectum and you might suspect a diagnosis of proctitis (likely viral).

The child responded very well to boluses of saline and went home later.

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