Case of the Week #2 (Oct. 16, 2006)
Written By: Bryan Jeun
You are a 1st year radiology resident on call. It has been a pretty uneventful Saturday evening, until you are paged by a 2nd year OB resident on
L&D. The call is regarding RJ, a two hour old neonate, who has had 2 episodes of violent, bilious vomiting. The resident informs you that RJ was
delivered via Caesarian section at 37 weeks gestational age that was complicated by moderate polyhydramnios (AFI of 30). RJ
appears to be a normal, healthy baby with 1 and 5 minute Apgar scores of 8 and 10, respectively. His 12th and 20th week ultrasounds were within
normal limits. Current vital signs include: BP 70/50, HR 130 beats/min, RR 32 breaths/min, and a T of 99.2 oC. Physical examination was significant
for mild abdominal distention. No other abnormalities were noted. RJ’s mother, PJ, is a 28 y/o G1P1A0 POD #0 s/p C-section who is stable and recovering well.
Her past medical history is not significant for diabetes or gestational diabetes. The OB resident has ordered plain AP and lateral films along with an
ultrasound scan and wants you to confirm the diagnosis.
