September 14, 2005
An 11-year-old boy had generalized abdominal pain followed by nausea and vomiting. He had neither diarrhea nor fever. Examination revealed a flat, diffusely tender abdomen with no palpable masses. Pigmented macules were seen on his lips and buccal mucosa. A partial bowel resection had been performed 5 years ago because of intussusception.