Description
A 14-year-old girl presented to the emergency department with a 1-week history of a lack of bowel movements, intermittent fevers, malaise and fatigue, for which she only took antipyretics. She also had a 1-month history of diffuse abdominal pain, abdominal distention (predominantly on the lower abdomen), decreased appetite, and a 1.5 kg weight loss. She had a history of chronic constipation and daily faecal incontinence since she was 8 years old, which was inconsistently treated with unspecific laxatives and weekly enemas. There was no history of hospitalisation or medication use (antibiotics, Proton Pump Inhibitors or steroids) during the 6 months prior to presentation.
On admission, the temperature was 38.2°C; heart rate was 84 beats per minute; respiratory rate was 24 breaths per minute; and blood pressure measured 90/90 mm Hg (systolic pressure <5th percentile). Her height was 155 cm (38th percentile), weight was 32 kg (2th percentile) and body mass index was 13.3 (percentile...
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