Rumination disorder (DIFFERETIALS ...Gerd /achlasia /iron deficency anemia )

Summary

This transcript discusses a case involving a 1.5-year-old child who was admitted to the hospital due to persistent vomiting and unusual behavior for five days, particularly after drinking milk or water. The child exhibited symptoms of placing their mouth and hand together and vomiting. Despite normal consultations with the ENT department and a thorough examination, no improvements were observed. After further observation, the child was referred for a consultation with child psychiatry and pediatric specialists, indicating that the case may involve complex medical or psychological factors.

Takeaways

• 😀 A one-and-a-half-year-old child was admitted to the hospital with a history of persistent vomiting lasting five days.
• 😀 Vomiting occurred specifically after the child consumed milk or water, followed by the child putting their hand in their mouth.
• 😀 The vomiting persisted for three days during the child's hospital admission.
• 😀 Consultation with an ENT (Ear, Nose, and Throat) department revealed no significant findings.
• 😀 Gross examination of the child's throat and neurological examination were both normal.
• 😀 Despite the initial evaluation, no improvement was observed in the child during their hospital stay.
• 😀 The child was referred for a consultation with pediatric psychiatry and pediatrics specialists.
• 😀 The case highlights a need for further investigation beyond basic examinations due to persistent symptoms.
• 😀 The child’s behavior—vomiting after drinking liquids—suggests a possible underlying psychological or developmental issue.
• 😀 No clear diagnosis was provided during the initial phase of observation, requiring additional specialist consultations.
• 😀 The case underlines the complexity of diagnosing pediatric conditions, especially when common physical causes are ruled out.

Q & A

What is the age of the child in the case presented?

The child is one and a half years old.

What symptoms did the child present with upon admission?

The child had persistent vomiting and behavioral changes over the last five days.

What kind of vomiting did the child experience?

The child vomited after drinking milk or water, and exhibited a hand-to-mouth behavior before vomiting.

How long did the vomiting persist during the child's hospital stay?

The vomiting persisted for three days during the child's hospitalization.

What initial diagnostic tests were performed on the child?

X-rays were taken, and consultations were made with the ENT department, but no significant findings were noted.

Were there any abnormal findings in the neurological examination?

No, the neurological examination was normal.

What was the outcome of the initial observation of the child?

Despite the initial observations, there was no improvement in the child's condition.

Which specialists were consulted after the child's condition did not improve?

Consultations were sought from child psychiatry and pediatric specialists.

What might be the significance of consulting both child psychiatry and pediatric specialists?

Consulting both specialties likely suggests a consideration of both physical and psychological factors in the child's symptoms, especially given the lack of improvement after standard medical evaluations.

How did the child’s behavior and vomiting pattern relate to their feeding?

The vomiting occurred specifically after drinking milk or water, and the child displayed a hand-to-mouth behavior before vomiting, which could suggest a behavioral or sensory issue.