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CASE REPORT
Feeding difficulty in an infant: an unusual cause
  1. Syeda Kashfi Qadri1,2,
  2. Veena Logarajah1,2,
  3. Shireen Anne Nah3,4,
  4. Saumya Shekhar Jamuar1,2
  1. 1Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
  2. 2Paediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
  3. 3Department of Paediatric Surgery, KK Women’s and Children’s Hospital, Singapore, Singapore
  4. 4Surgery Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
  1. Correspondence to Dr Saumya Shekhar Jamuar, saumya.s.jamuar{at}singhealth.com.sg

Summary

A 10-month-old girl, with spondyloepiphyseal dysplasia congenita and posterior cleft palate had presented at 23 days of life with history of feeding difficulties. A diagnosis of oropharyngeal dysphagia and gastro-oesophageal reflux disease was made, for which she was started on nasogastric tube feeding and oral ranitidine. However, she continued to have poor development of oropharyngeal skills, persistent reflux as well as poor growth and was planned for gastrostomy at 10 months of age. She underwent soluble upper gastrointestinal contrast study prior to gastrostomy placement to rule out anatomical causes of vomiting, which showed the greater curvature of the stomach to be lying above the lesser curvature, suggesting a diagnosis of gastric volvulus, likely chronic, given that she did not have a history of abdominal distension, irritability or recurrent vomiting. On diagnosis of gastric volvulus, our patient underwent laparoscopic gastrostomy creation and is doing well postoperatively.

  • paediatrics
  • failure to thrive
  • congenital disorders
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Footnotes

  • Contributors SKQ and SSJ collected the data and did the initial analysis. SKQ drafted the initial manuscript and SSJ approved the final manuscript as submitted. SSJ had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data presented. VL and SAN performed the clinical interpretation, analysis, reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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