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April 12, 2024

A 17-year-old high school student with a history of asthma is evaluated for recurrent epigastric discomfort.

A 17-year-old high school student with a history of asthma is evaluated for recurrent epigastric discomfort. On exam, a 1 cm midline protrusion is noted in the epigastric region between the xiphoid process and the umbilicus. His skin is otherwise normal. Auscultation reveals normal bowel sounds. Percussion is also normal and nontender. Palpation of the midline protrusion reveals a soft mass like structure that is mildly tender. He has no guarding or rebound tenderness. When standing, the nodule is a little more prominent. What is the most likely diagnosis?

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