Hussaini I., 10

Hussaini is a dramatic child who hardly stays at home, he is passionate about football and is always found on the pitch playing football. He aspires to become a Super Eagle star. He was well until about 3 weeks before presentation when he started having fever, abdominal pain, and vomiting. The fever is said to be low-grade and continues associated with colicky abdominal pain and progressive abdominal swelling. There is a history of constipation. Since the onset of the fever, the patient was said to have been given several over-the-counter medications which the guardian could not ascertain their names, but no improvement. On examination: looking toxic, in distress, febrile (38.2 degrees centigrade), pale, wasted Abd - distended, moves with respiration, generalized tenderness, and guarding with ascites Assessment: Acute abdomen secondary to bowel perforation.

Hussaini was diagnosed with acute abdomen due to bowel perforation. He underwent emergency surgery, which involved resection of the perforated bowel segment and anastomosis. The recovery process was closely monitored in the paediatric ward. Post-operative care included pain management, fluid resuscitation, and antibiotic therapy. The child was initially fed through a nasogastric tube and gradually progressed to oral feeding. The outcome was successful, with the child making a full recovery: no surgical site infection and no other complications. The child was able to resume normal bowel function following the surgery. He was later discharged from the hospital after 13 days, with oral medicines and a 1-week follow-up appointment to monitor for any potential complications. Parents were very happy having received help from helpster.

Acute abdomen secondary to bowel perforation is a serious life-threatening condition, but very urgent intervention can reduce its associated highest risk of mortality. Otherwise, the child will die without the surgical intervention. The plan is: -Keep Nil Per Os (NPO) -Do urgent CT abdomen -FBC, GXM 3 Units of blood -EUCr -ESR -Arrange the patient for urgent explorative laparotomy.