Abdominal pain, tachycard...

A girl aged 13 years with a body mass index, of 56.7 kg/m2 complains about abdominal pain, tachycardia, and shortness of breath. She began to have generalized stomach pain two days later, along with nonblood, nonbilious emesis, and watery diarrhea. In addition, the patient reported increased thirst and new bowel and bladder incontinence. She had trouble breathing, tachypnea, and a generalized feeling of weakness that morning, prompting her visit to the pediatric emergency department.An electrocardiogram (ECG) was used to check for right-heart strain, and sinus tachycardia was found to be a sign of ischemia. A CT angiography of the chest was ordered, as well as a CT abdomen/pelvis with IV contrast imaging. The following are the outcomes: complete blood count with leukocytosis of 30 K/mm3 with 8% bands; hemoglobin, 10.7 g/dL, hematocrit, 33.6 g/dL, platelets, 649 K/ mm3; C-reactive protein, 56 mg/dL (<0.5 mg/dL); lactate, 2 mmol/L (normal< 2.3 mmol/L); hemoglobin, 10.7 g/dL, hematocrit, 33.6 g/dL, platelets, 649 K/ mm the D-dimer level was 19 mg/L FEU (normal < 0.5 mg/dl FEU). A complete metabolic panel, venous blood gas, troponin, lipase, urinalysis, and urinary pregnancy test are within the reference range.