A 1 year old boy presents with intermittent crying for 1 day. There is no history of fever, vomiting, diarrhea, or urinary frequency. He was completely healthy previously, with normal growth and development. All immunizations are up to date.
WBC: 8,000/mm3 (5,500-15,500) Hb: 13 g/dL (10.5-13.5) Hct (PCV): 35% (33-49) Platelets: 288,000/mm3 (150,000-450,000) Blood film: Normal
There is a target lesion in the right upper abdomen on transverse imaging. The lesion shows the pseudokidney sign on longitudinal imaging. No other abnormalities are detected.
The oral and intravenous contrast CT study confirms the presence of a target lesion in the right upper abdomen. No other abnormalities are detected.
You attempt to rationalize why upper GI endoscopy is indicated, and fail.