Fabricated or Induced Illness Case 1

A 6-year-old girl is seen in ED with her Mum. The history is of recurrent peri-umbilical abdominal pain for 6 months. She is otherwise well but has missed 4-5 weeks of school in that time because of her pain.

Give 5 possible diagnoses.

You take a full history. Which of the following might point towards a non-organic cause?

Select one or more options.

Mum reveals that she thinks the pains are due to painful periods.

Give 4 features on the examination that might indicate precocious puberty.

Her examination reveals that she is pre-pubertal. Previous blood tests confirm this. You are concerned about FII as the reported symptoms do not match the physical findings and investigations. However you must consider other potential diagnoses.

Which of the following are differentials for vaginal bleeding?

Select one or more options.

Given your concerns regarding FII, state 3 actions you should take.