title: Food refusal as an unusual presentation in a toddler with duodenal web.
abstract: Duodenal web most commonly presents with a history of vomiting and failure to thrive in the early infancy period. This study reports on a child who had an initial presentation of feeding intolerance and rare nonbilious emesis. The unusual presentation of food refusal directed the investigation to an upper endoscopy to look for evidence of gastrointestinal mucosal disease such as gastroesophageal reflux disease, peptic ulcer disease, Helicobacter pylori infection, and food allergy including celiac disease. The finding of duodenal web with a central aperture was unexpected but explains the mild degree of her gastrointestinal symptoms.
authors.affiliation: Department of Pediatrics, West Virginia University School of Medicine, Morgantown, 26506-9214, USA. wkarnsakul@hsc.wvu.edu
authors.forename: Wikrom
authors.initials: W
authors.lastname: Karnsakul
authors.forename: Stacey
authors.initials: S
authors.lastname: Gillespie
authors.forename: Mary L
authors.initials: ML
authors.lastname: Cannon
authors.forename: Tarun
authors.initials: T
authors.lastname: Kumar
mesh_terms: D004386:Duodenum / Q000002:abnormalities*; D001068:Feeding and Eating Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant