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Ronald Swanger, MD

Northern Navajo Medical Center




Acute Lymphoblastic Leukemia Presenting as Soft Tissue Mass

February 04, 2010

For 3 months, a 9-year-old boy had swelling of the left upper arm. An MRI scan obtained at another facility 1 week after onset showed extensive edema of the soft tissue at the midhumeral level. Laboratory results, including complete blood cell (CBC) count and Lyme titer, were normal.

Left-Sided Appendicitis in an 11-Year-Old Girl

January 01, 2008

An 11-year-old girl was brought to the emergency department (ED) after 3 days of intermittent, dull, nonradiating left lower abdominal pain. She also had 3 episodes of nonbloody, nonbilious emesis in the 2 days before presentation. Three days earlier, the patient had been vaccinated against influenza and varicella by her pediatrician.

Left-Sided Appendicitis With Intestinal Malrotation

January 01, 2008

In the ED, the patient was afebrile. The pain remained localized to the left lower quadrant; it increased with palpation and decreased when the child lay still. A transabdominal pelvic ultrasonogram was normal: specifically it showed no ovarian torsion.