Gastric ulcer presenting as gastroesophageal reflux and apnea in a term neonate.
Apnea in the neonatal period frequently is associated with prematurity. Full-term infants who develop apnea usually have associated clinical conditions such as infection, shock, metabolic disorders, neonatal abstinence syndrome, intracranial pathology, and gastroesophageal reflux. Gastric ulcer also is a rare phenomenon in the neonatal period. We describe a full-term infant presenting with apnea. Upon investigation, a 6-channel pneumocardiogram revealed central apnea and multiple episodes of low esophageal pH (< 4), which is suggestive of gastroesophageal reflux. This was confirmed by an upper gastrointestinal series. A small antral ulcer crater also was demonstrated. When assessing the etiology of apnea in a full-term infant, gastroesophageal reflux and gastric ulcer should be considered.
Skinner
S
S
Department of Medicine/Pediatrics, Maricopa Medical Center, Phoenix, Ariz., USA.
Naqvi
M
M
Biskinis
E K
EK
D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001049:Apnea / Q000209:etiology*; D020117:Cisapride; D004947:Esophagus / Q000503:physiopathology; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D008297:Male; D009666:Nose / Q000502:physiology; D010100:Oxygen / Q000097:blood; D010880:Piperidines / Q000627:therapeutic use; D012123:Pulmonary Ventilation / Q000502:physiology; D011674:Pulse; D011899:Ranitidine / Q000627:therapeutic use; D012119:Respiration / Q000502:physiology; D013276:Stomach Ulcer / Q000150:complications* / Q000188:drug therapy
D000897:Anti-Ulcer Agents; D010880:Piperidines; D011899:Ranitidine; D010100:Oxygen; D020117:Cisapride