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Picture of the Month Quiz

Image of a 9-month-old previously healthy infant presented to an emergency department with an episode of gagging with feeds

Figure.

A 9-month-old previously healthy infant presented to an emergency department with an episode of gagging with feeds. His parents reported that he had been well until the day of admission and had noted gagging with his dinner that evening, with 1 subsequent episode of nonbilious, nonbloody emesis. He had no fever, cough, rhinorrhea, respiratory distress, or excessive drooling. He had been gaining weight well, and there was no history of head trauma. The child had several toddler and preschool-aged siblings at home; thus, a concern for foreign body ingestion was raised.

On physical examination, the child was afebrile with stable vital signs. He was playful and interactive. Examination findings of the oropharynx, neck, lungs, heart, abdomen, and genitalia were normal. Because of the history of possible foreign body ingestion, chest and abdominal radiography were performed, which suggested a mass in the stomach. Images from abdominal ultrasonography (Figure, A) and computed tomography (Figure B) are shown.

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