FAMILY HEALTH

PEDIATRICS

GENERAL MEDICINE

<p>A 14-year-old boy reported sporadic complaints of abdominal pain, and constipation for two years. He had been admitted to various hospitals several times for Iron Deficiency Anaemia (IDA), which required iron treatment. He appeared pale and nervous during the presentation. On physical examination, there was a decrease in bowel sounds and pain in the lower abdominal quadrants and a solid mass on rectal examination. Plain abdominal radiography revealed widespread opacity in the region of the descending and sigmoid colons (Fig. 1). Lab results showed: hemoglobin 5.5 g/dL, hematocrit 19%, average red blood cell size 51 fL, average red blood cell hemoglobin 15 pg, average red blood cell hemoglobin concentration 28.9 g/dL, red blood cell distribution width 28.9%, platelets 608,000/mm^3, white blood cells 14,200/mm^3, serum iron 6 &micro;g/dL, iron-binding capacity 372 &micro;g/dL, reticulocytes 1.04%, and serum ferritin 1 mg/dL. The peripheral blood sample revealed pale and small red blood cells. Pica history was also present. The results of a peripheral blood smear revealed hypochromic, microcytic erythrocytes.</p>

<p>A packed red cell transfusion was given to the patient prior to the surgical procedure. Under general anaesthesia, the anal canal was dilated with forceps, and one kg of stones was extracted from the sigmoid colon. The Department of Pediatric Psychiatry concluded that the patient appeared normal. After starting iron treatment, the patient&#39;s anemia&nbsp;improved and he was discharged.</p>