Abstract

We present a medical case of a 16-year-old girl admitted to our clinic because of severe abdominal pain. A month before she had undergone laparotomy because of suspected appendicitis. During the operation the initial diagnosis had not been confirmed. Since that time she had often complained of severe paroxysmal abdominal pain.

On admission to hospital, she was in poor general condition, on physical examination pathological resistance with tenderness was found in the gastric area. X-ray examinations showed disturbance of the upper gastrointestinal tract’s motility such as high paralytic ileus several times. Extensive diagnostics did not help to find the cause of described abnormalities. During hospitalisation we observed exacerbation of the patient’s condition. She suffered extreme pain correlated with the intensification of paralytic symptoms. That is why opioids administration was necessary. Because of the patient’s depressive mood, which was first connected with prolonged somatic complaints she underwent psychiatric consultation. Psychiatrics diagnosed depressive syndrome with somatization. Good therapeutical effect of clomipramine confirmed the diagnosis.

We present this case because of many difficulties in establishing proper diagnosis and because of limited analogical reports in young patients in both Polish and foreign literature.