There are no other family members who are ill at home. Past medical history reveals this patient to be the first born product of an uncomplicated full term pregnancy and spontaneous vaginal delivery. General impression upon entering the room is of a non-toxic appearing white female who has just vomited a small feeding. The anterior fontanel is slightly depressed. Tympanic membranes are normal in appearance.
Nares are clear without congestion.
The oral mucosa is slightly dry, pink and without exudates. Neck is supple without adenopathy or meningeal signs. Chest is clear, with normal heart sounds. Abdomen is soft nontender without palpable masses. However, serial physical exam reveals a visible mobile mass which traverses the abdomen in approximately one minute.