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Picture of the Month Quiz

A 7-year-old girl fell while running. It seemed to be a minor fall, and she was fine immediately after the incident. Ten to 15 minutes later, she began to experience mild abdominal and left anterior chest pain. Breathing difficulty developed, and she was taken to the emergency department. She was afebrile with a normal heart rate. Her respiratory rate was 20/min, and she maintained greater than 95% oxygen saturation. A chest examination showed decreased breath sounds on the left and dullness to percussion at the left base of the lung. The abdomen was tender in the epigastric region and was soft and nondistended without guarding or rigidity. Chest and abdominal radiography showed a gaseous pattern (Figure).

Figure

Figure.

What is your diagnosis?

For a complete discussion of this month's case, read next month's Picture of the Month—Quiz Case. For a complete discussion of last month's case, read this month's Picture of the Month—Quiz Case.