A 14-year-old African American boy presented to a primary care clinic with diffuse abdominal pain. He was in no acute distress and was conversational, but he was a poor historian. He reported a 2-week history of abdominal cramping, particularly at night. The pain was described as "all over," increasing in severity over time, not associated with particular foods, and not alleviated with bowel movements. During the first week, the pain was intermittent and mild (3 to 4 out of 10), but it became constant and worsened to 6 to 7 out of 10 in severity during the 4 days before he presented. He denied having fever, constipation, hematochezia, or change in urine color. He denied recent travel. Although the patient denied having any life stressors, the pain had caused him to miss several days of school and basketball practice.
J Pediatr Health Care. 2014;28(5):444-450. © 2014 Mosby, Inc.