0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

SPECIAL FEATURE

Allen S. Melemed, MD; Samy Desouky, MD; David B. Allen, MD; Enid Gilbert-Barness, MD
Am J Dis Child. 1993;147(2):209-210. doi:10.1001/archpedi.1993.02160260099033.
Text Size: A A A
Published online

A 2½-year-old girl presented with bilateral breast development first noticed 5 days previously. Each breast was hypertrophied. One day later, she returned with abdominal pain, fatigue, and irritability. She had diffuse abdominal and rectal tenderness that was greater on the right side. An abdominal roentgenogram revealed the absence of bowel gas in the right lower quadrant. An abdominal ultrasound study showed a 6×10-cm multicystic mass in the lower abdomen (Fig 1).

On examination, she was pale and uncomfortable. Vital signs were as follows: heart rate, 170 beats per minute; blood pressure, 100/45 mm Hg; and respiratory rate, 45 breaths per minute. The abdomen was tense, with absent bowel sounds in the right lower quadrant. There were no palpable masses, although the examination was suboptimal because of distention and guarding. Breast examination revealed 2-cm hypertrophy without increased areolar pigmentation. She appeared to be a normal prepubertal female. Admission laboratory data were

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();