Project Description

A Rare Cause of Failure to Thrive

History of Present Illness:

After a telephone consultation on Saturday, we see a 5 month old girl 2 days later on Monday for the evaluation of failure to thrive combined with repetitive vomiting.

The clinical examination shows a girl in good general condition with normal vital signs for her age and no fever. The weight is 5.68kg (P 5) with a height of 65.5cm (P 72). We see a relevant percentile decline in weight from P 80 at the age of 1 month to P 33 at the age of 4 months.

In the patient history, repetitive vomiting is described from around birth until the third month of life. In the last 3 weeks, the vomiting has started again, usually 10 minutes after breastfeeding, resulting in the mother feeding her child with a mixture of water, salt and sugar.

Initially blood gas analysis including the electrolytes is performed:

Venous Blood Gas:

Quiz

Which further evaluation do you need to determine the cause of the electrolyte imbalance?
Which illness are these results typical for?
Which infusion solution would you choose?