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Clinical Decision Rewritten Paper

Chief complaint: “ left lower quadrant pain”

History of present illness: A 3 year old female presents to an emergency department for evaluation of stomach pain that has been present for eight hours. The child is accompanied by her mother, who is otherwise the sole historian. Patient’s mother states that the pain began suddenly, with a loud outburst of crying this morning at 8. Using the pediatric pain scale, the child asserts that her pain is 7 out of 10. The child states that the pain “ hurts really badly”, she points to her left lower quadrant when asked to localize the pain. Patients mother states that she believes that the pain has been on and off since the onset, but, as the day has progressed it seemed to become worse which is the reason for bringing her daughter to the ED.  She asserts that everything has been fine with her daughter before this morning, only recently a viral respiratory infection had occurred 1 week ago, treated supportively with with children’s Motrin for symptomatic relief. The patient’s mother asserts that she noticed her daughter tucking her knees. To her chest when the pain started. The maneuver seemed  to make her feel slightly better. To her mother’s knowledge, patient has not taken any medications or ingested any foreign substance. Bowel movement this morning was positive for blood and a jelly like appearance.; mother noticed a great change in pattern and form of stool, fever had not occurred in past. Patients last meal was regular, hot oatmeal this morning. She has not eaten anything since morning. Her daughter maintains a healthy diet. The patient’s mother denies episode of nausea or vomiting; denies problems urinating. Denies any history of abdominal pain or trauma to the abdomen.