http://omjournal.org/articleDetails.aspx?coType=1&aId=2483

http://omjournal.org/articleDetails.aspx?coType=1&aId=2483

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An eight-year-old girl presented with a history of fever, nonbilious vomiting, and abdominal here pain lasting three days.She was referred from a peripheral hospital for suspected acute appendicitis and admitted to the pediatric emergency department.She had difficulty breathing and pain in the left side of the cubs foam finger chest referred to the back.On examination, her vitals were stable with oxygen saturation of 92% in room air.Abdominal examination revealed diffuse tenderness without guarding or rebound tenderness.

Chest auscultation showed reduced breath sounds on left-sided posterior lung fields.She was subjected to an erect chest X-ray and abdominal ultrasound.