Anyone up who knows what this could be? DS in pain.

[daydreaming3]

DS (4) was fine all day yesterday. We went out for dinner last night and he ate all of his (including beans which may be relevant). We then had our weekly family movie night, DS had some squash and a tiny bit of chocolate whilst watching the movie. Normally on movie night we let the DC stay up later than normal so they usually sleep in aswell.

He's now woken up at 4 this morning crying saying his stomach hurts. I instantly thought its because he ate so much last night so encouraged him to go to the toilet which he did. He did a poop but said his stomach was still hurting.

He's now white as a ghost, feels really cold and clammy to the touch and is saying his tummy hurts so much he can't stand up. I've got him to walk a little bit which he has but he's bent over whilst doing it bless him.

I don't want to take him anywhere yet incase it is just wind from the beans but I would have thought going to the toilet would have helped ease that a bit which it hasn't. Anyone had this with their little ones?

Ask them what his PEWS score is?

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Sorry your little one is poorly. My retired Dr Dad used to warn us about handlebars hitting our chest/stomach area when out riding our bikes - he said that trauma to internal organs can sometimes be missed and serious. I hope your LO is much better soon.

I agree he needs at least to be monitored/ observed on the ward to see how he is doing overnight then reviewed in the morning again by the Drs/ consultant ( presuming he is not unwell in the night in which case night on call Dr will see him)

You are doing great OP! I keep checking in to see how he is. Do NOT leave unless you are happy with his condition. Poor little man sounds so sick.

I remember when I was a surgical registrar a child being sent home and coming back after a week with ongoing pain . They had an appendix abscess.

I’ve also seen doctors getting it right hundreds of times. There is a balance between trusting professionals and advocating for your child. OP is doing brilliantly at the moment.

Just had ultrasound results back and they are fine. Nurse said they probably won't do a Ct scan but they have said they will most likely keep him in now to observe. Which at least is a bit of a positive as I am too worried to take him home when he's like this

OP my DD had a very similar experience, about 48 hours ahead. Suspected appendicitis but they eventually ruled it out and now think it's a gastric bug. Possibly that mesenteric thing someone posted upthread. The pain my daughter was in was unreal, screaming in foetal position to moaning with eyes closed unable to speak. Reminded me of labour pain. She vomited up any oral pain relief. Eventually she got IV paracetamol and some morphine. Every time pain relief eases she cramps again but after a horrific 12 hours it eased a bit and now she can manage with oral pain relief only so is being discharged. I can't believe it's from a tummy bug but it's something to do with lymph nodes in abdomen. I was over on the chat thread last night moaning about my snoring room mate. She is still a very sick weak child and a bit traumatised by the whole thing, crying uncontrollably all afternoon.

Has he played with water beads at any point in the past? Those can be eaten by accident and slowly grow to form a bowel obstruction. This takes a while so the timeline can be weeks or even months. E.g. If he played with them a year ago, a single lost bead can dry up to the size of an ice cream sprinkle and be accidentally ingested at any point down the line. The transparent beads do not show up on xrays but are marginally visible on CT scans.

I’m sorry if I’m needlessly adding to the many speculations, but have they ruled out any organ damage from the fall? I just remember reading about a child who suffered pancreatic trauma after falling off their bike, which the doctors missed. I presume any x-Ray would bring this up but maybe it couldn’t hurt to ask?

The bike accident is worrying. That is exactly what happened to Martha Mills. A slow speed slip on her bike caused damage to her pancreas and she died from sepsis.

That sounds sensible. If he is unwell they will ask the Dr to rv. Just keep communicating especially if he seems to become more unwell x

Yes I agree

@Morty12 this is the same story I’m referring to.

I think the drs are getting a harsh deal here personally, it looks like they did a lot of tests and quickly to rule out most things. His bloods and x ray and ultrasound being ok is probably why they feel no need for a CT scan - if his OBS are ok including BP is a good sign.
he is staying in over night so if any of obs etc become worrying then they can change course to a CT.

I was just scrolling to see if anyone had mentioned this story as I thought of it when the OP mentioned he'd had an accident on his bike. I think a scan would have shown anything though hopefull

👆well done on pushing for your child to remain overnight OP and do not hesitate to demand a second opinion, and yes ask them about sepsis as you just never know and there are tests they can do to rule it out

They have the option of a CT if needed.

Echoing the sepsis concerns.

I read an article recently about a girl who hit her chest/abdomen on her handlebars and died shortly afterwards from sepsis following pancreatic trauma. I've found the original article, although the one I read was about the same case but more recently written.
https://www.theguardian.com/lifeandstyle/2022/sep/03/13-year-old-daughter-dead-in-five-weeks-hospital-mistakes
does any of this ring a bell with symptoms?

I think this is a good plan for now. The clear diagnostics so far are really encouraging but I would be very reluctant to leave like you. Can anyone bring you in some home comforts? They always gave me a z bed when my DS was in and I wore my cosiest clothes and an eye mask/ear plugs to rest a bit (never slept particularly but liked to block it all out a bit). Podcasts are great for staying calm. Nice food, drinks, paracetamol for inevitable lack of sleep headache helped too.

Yes because of the Martha Mills case you can now ask for a second opinion if you feel unhappy or ignored with the first opinion. So stick to your guns. Xxx

OP, if he had a handlebar injury then with his symptoms it could well be damage to one of his internal organs (spleen, liver, pancreas etc) - with young children everything is quite squeezed together so a 'chest' injury can affect abdominal organs in a way you wouldn't expect for an adult. His symptoms definitely do not indicate muscle damage, vomiting and lethargy would not be associated and nor would clamminess and low temperature.

You are doing the right thing to stand your ground and reiterate that he is very poorly, seems to be deteriorating and you are very concerned. His bloods results are important and his SATS should be taken regularly.

I would also recommend you ask doctors "could this be sepsis?" Clamminess and low temperature, especially in younger children, can be a sign of infection as can lethargy and vomiting.

I know you are worried and do not want to make you feel more anxious but I am encouraging you to feel sure that you are doing the right thing and advocating for your child and for medical attention.

My little girl was very ill over Christmas with what turned out to be burst appendix and sepsis. She was 5. Definitely not too young and displayed symptoms just as your little one is doing. We got sent home on the first a&e trip but was back within 12 hours and then diagnosed as appendicitis. She was on IV antibiotics within an hour and had the appendectomy the next day where they found it to have burst and she was actually very poorly with sepsis and they said she was very lucky that we brought her back when we did otherwise the outcome could have been very different. Push for further tests.

@Ukholidaysaregreat you have always been able to do that.
he has had an ultrasound which would look at pancreas / spleen.
his bloods were good - which would indicate no infection at current.
no fever- good observations.
there is nothing screaming sepsis- or a severe infection as sepsis is used on terminology wrong a lot of the time.
he is in for observation and of course things can change and they can review and change course if things do.