A healthy 6-year-old boy presented to the emergency department after experiencing a bicycle handlebar injury. He complained about abdominal pain and had vomited twice. At physical examination, according to the Advanced Pediatric Life Support protocol, he had normal vitals results with pain during palpation of the left abdominal region without guarding. His hemoglobin level was 12.3 g/dL (to convert to grams per liter, multiply by 10) (normal value, 10.5-16.1 g/dL), amylase 68 U/L (to convert to microkatals per liter, multiply by 0.0167) (normal value, <85 U/L), and lipase 25 U/L (normal value, <60 U/L). A plain chest radiography result showed no signs of traumatic injury. Abdominal ultrasonography results showed a bowel loop with a thickened wall in the left abdominal region with no free abdominal fluid. He was admitted to the pediatric ward for close observation. The next day, his vomiting persisted, especially after oral intake. Computed tomography with oral and intravenous contrast was performed (Figure 1).

一个健康的6岁男孩在受到自行车手把伤害后出现在急诊室。他抱怨腹痛，呕吐了两次。在体格检查中，根据《高级儿科生命支持》协议，在没有监护的情况下，他在触及左腹部区域时具有正常的生命体征结果，并伴有疼痛。他的血红蛋白水平为12.3 g / dL（换算成每升克，乘以10）（正常值，10.5-16.1 g / dL），淀粉酶68 U / L（换算成每升微卡塔尔，乘以0.0167）（正常值，<85 U / L）和脂肪酶25 U / L（正常值，<60 U / L）。胸部X线平片检查结果未显示出外伤的迹象。腹部超声检查结果显示，左腹部区域肠壁增厚，无游离腹水。他被送进儿科病房进行仔细观察。第二天，他的呕吐仍然存在，尤其是在口服之后。进行了计算机断层扫描，并进行了口服和静脉造影（图1）。