A case of prune belly and a 10-year-old with bloody stool

She passes bloody stools intermittently

A 10-year-old female presents with a five-month history of constant fever (39 – 40 C). Hepatosplenomegaly is noted on exam. She is anemic, and has a high copy number of EBV-DNA. Colonoscopy reveals large ulcers and neoplasm in the ileocecum, as well as the ascending, transverse, and descending colon. Find out what the biopsy revealed.


What is this patient most likely to develop?

A full-term infant male is born to a healthy 32-year-old female. Newborn examination reveals generalized hypotonia, a distended abdomen with visible peristalsis and thin wrinkled skin, and an empty scrotum. A sweep along the inguinal canals bilaterally indicates that both testes are present.

  • Wilms tumor

  • Cecal volvulus

  • Chronic kidney disease

  • Rectal prolapse

See the answer


These cases were originally published in the August 10, 2019 edition of The Differential for Pediatrics newsletter. The Differential is our premium newsletter which rounds up the most interesting and useful clinical cases based on your specialty. To sign up for this email in any of its 10 specialty-specific editions, download the Figure 1 app and update your email preferences.