title: An unlikely cause of severe malnutrition in a 3-year-old girl with previous gastroschisis.
abstract: A 3-year-old girl with previous gastroschisis associated with jejunal and colonic atresia presented with severe oedema, abdominal pain and diarrhoea. Clinically she was malnourished. Serum albumin and concentrations of micronutrients were low. A barium meal examination showed jejunal dilation. A stricture was suspected and the patient was taken to theatre where an 8 cm length of bowel was resected including a jejunal stricture at the point of previous atresia repair. Inside the proximal dilated jejunum was a large trichobezoar (hairball), thought to be acting as a ball valve inside the bowel. This girl made a rapid recovery after surgery. Her nutritional state improved, symptoms resolved and serum biochemistry normalised. She remains well at follow-up with normal blood results, normal albumin and no diarrhoea.
authors.affiliation: Department of Paediatric Gastroenterology, University Hospital Southampton, Southampton, UK.
authors.forename: J J
authors.initials: JJ
authors.lastname: Ashton
authors.affiliation: Department of Paediatric Surgery, University Hospital Southampton, Southampton, UK.
authors.forename: S
authors.initials: S
authors.lastname: Blackburn
authors.affiliation: Department of Paediatric Surgery, University Hospital Southampton, Southampton, UK.
authors.forename: D
authors.initials: D
authors.lastname: Burge
authors.affiliation: Department of Paediatric Gastroenterology, University Hospital Southampton, Southampton, UK.
authors.forename: R M
authors.initials: RM
authors.lastname: Beattie
mesh_terms: D002675:Child, Preschool; D003937:Diagnosis, Differential; D013505:Digestive System Surgical Procedures / Q000379:methods; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D020139:Gastroschisis / Q000150:complications* / Q000601:surgery; D006801:Humans; D044342:Malnutrition / Q000175:diagnosis / Q000209:etiology*; D011860:Radiography, Abdominal; D012720:Severity of Illness Index