Ryan G., 6

Ryan is a six-year-old boy who lives in one of the informal settlements with his grandmother and brother. He is enrolled in PP2 and is a cheerful, friendly and energetic child who enjoys attending school and playing outdoor games with other children. Through these activities, he continues to build friendships and develop his communication and teamwork skills. Ryan dreams of becoming a doctor so that he can help others. On 13 August 2026, Ryan was taken to a local dispensary after developing vomiting accompanied by abdominal pain. The vomit was small in quantity, non-projectile and did not contain blood. There was no reported abdominal guarding or rebound tenderness during the initial assessment. He was prescribed cefixime, promethazine and paracetamol before being discharged to continue treatment at home. However, his condition did not improve significantly, and the symptoms persisted. He was therefore taken back to the health facility on Saturday for reassessment. Following evaluation, Ryan and his caregiver were advised to seek specialized care at our facility for further investigation, appropriate treatment and continued management.

Ryan has a severe acute abdomen caused by a ruptured appendix and pelvic abscess. A ruptured appendix means the infected appendix has burst, allowing infection to spread within the abdomen. A pelvic abscess is a collection of infected pus in the pelvic cavity. This was discovered intraoperatively. He requires drainage of the pus, repair of the appendix, antibiotics and supportive care, as delay may lead to sepsis and death. With the timely care and follow-up, a good recovery is expected.