Short communication, Note
Hiatal hernia and failure to thrive in a 2-year-old boy
Tamara Petrić
; Department for pediatric nephrology and gastroenterology, Clinics for children's diseases, Clinical hospital centre Rijeka, Rijeka, Croatia
Irena Barbarić
; Department for pediatric nephrology and gastroenterology, Clinics for children's diseases, Clinical hospital centre Rijeka, Rijeka, Croatia
Abstract
Aim: Failure to thrive constitutes a broad spectrum of diseases with multiple etiologies and a variety of clinical manifesta ons. The most common cause is malabsorption while other causes are very rare. The aim of this report is to emphasise the importance of usual diagnostic approach.
Case report: We present a 13 month old boy with symptoms of
gastroesophageal reflux disease and failure to thrive. Laboratory findings showed anaemia, upper endoscopy active bleeding from acute ulcer in hiatal hernia and X-ray study confirmed hiatal hernia. Despite drug therapy and hypercaloric nutri on he did not gain weight. We performed usual diagnostic procedure and confirmed coeliac disease.
Discussion: Hiatal hernia in children is very rare and usually asymptomatic. Children with symptoms respond well to drug therapy. Paraesophageal hernia is very rare but with more complications such
as volvulus and incarceration. Coeliac disease is the most common cause of malabsorption in children (1%). The typical symptom is failure to thrive because of gluten ingestion and the only therapy is life long gluten free diet.
Conclusion: As coeliac disease is a very common cause of failure to thrive in children, it is important to perform usual diagnostic tests in every hypothrophic child in spite of presence of other possible causes.
Keywords
failure to thrive; hiatal hernia; malabsorption syndrome
Hrčak ID:
38816
URI
Publication date:
1.6.2009.
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