Baseball Sliding Injury - Page #4

Working Diagnosis:
Type II Autoimmune Hepatitis

Initial injury management consisted of symptomatic treatment with ice and analgesics for the pain. He was instructed to avoid all contact or collision sports due to splenomegaly while undergoing further evaluation. The pediatric gastroenterologist instituted treatment with prednisone 40mg daily, azathioprine 100mg at bedtime and prevacid 30mg daily.

The patient was initially seen by pediatric gastroenterology every 4 to 6 weeks. He was tapered off prednisone once his liver function panel normalized. Upon clinical follow-up, his symptoms improved, splenomegaly was not appreciated and he was finally cleared to resume full sports activities.

He has returned to full sports participation without further incidents.

Editor's Comments:
This case demonstrates the importance of a complete physical exam. Without a thorough abdominal exam, diagnosis and treatment would have been delayed or missed altogether.

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