Cases reported "Failure to Thrive"

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11/21. Marshall-Smith syndrome: further delineation.

    We have reported a case of the Marshall-Smith syndrome, a condition characterized by accelerated bone maturation, dysmorphic features, respiratory compromise, failure to thrive, neuro-developmental abnormalities, and death in early infancy. Early evaluation of upper airway obstruction in these children may be important in prolonging life. Although the prognosis has been poor to date, early recognition and aggressive multi-disciplinary therapy may permit further investigation into the cause and appropriate management of this disorder.
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ranking = 1
keywords = airway obstruction, obstruction, airway
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12/21. Endoscopic surgical management for laryngomalacia. Case report and review of the literature.

    laryngomalacia is the most common of the many causes of respiratory stridor in the newborn. It may be identified by fiberoptic nasopharyngoscopy in the nursery or office. Several anatomic mechanisms of supraglottic collapse have been reported in the literature. The most common is a narrowing of the supraglottic airway with blockage of the glottic opening by the redundant tissue of the aryepiglottic folds. Although surgery rarely is indicated, severe airway obstruction, necessitating surgical intervention, can occur. Resection of supraglottic tissue should be performed only as an alternative to tracheotomy. Surgical procedures ranging from tracheotomy to epiglottidectomy have been advocated. Direct visualization of the obstructing tissue by nasopharyngoscopy allows the planning of an appropriate surgical procedure. In a patient with lateral supraglottic collapse, deep resection of the epiglottis would be expected to weaken the support of the aryepiglottic folds and aggravate the airway condition. Similarly, resection of tissue along the aryepiglottic folds will be useful only if preoperative evaluation demonstrates the obstruction to be at this location.
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ranking = 1.0966405181563
keywords = airway obstruction, obstruction, airway
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13/21. failure to thrive due to obstructive sleep apnea.

    The clinical features of two children with failure to thrive due to obstructive sleep apnea are presented. Both patients had subnormal growth velocities for height and weight for many months before diagnosis; both were underweight for height. Relief of their airway obstruction by adenotonsillectomy was promptly followed by catch-up growth and subsequent normal growth velocities. Obstructive sleep apnea should be considered in the differential diagnosis of failure to thrive in children.
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ranking = 1
keywords = airway obstruction, obstruction, airway
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14/21. failure to thrive associated with chronic ulcer disease in a 9-year-old boy.

    Chronic peptic ulcer disease is not generally considered to cause failure to thrive. We are reporting a 9-year-old child who suffered from chronic recurrent abdominal pain and failure to thrive. Investigation revealed that the child also had bacterial overgrowth and evidence of malabsorption. These findings were considered to be due to chronic peptic ulcer disease which caused intermittent small bowel obstruction and gastric outlet obstruction. Successful treatment of the ulcer alone resulted in catch-up growth and an end to the chronic recurrent pain. Recurrent abdominal pain when associated with atypical features or failure to thrive should be adequately investigated. Although rare, chronic peptic ulcer disease with its sequelae should be considered in the differential diagnosis of failure to thrive.
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ranking = 0.089143287004886
keywords = obstruction
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15/21. Obstructive hypertrophic adenoids and tonsils as a cause of infantile failure to thrive: reversed by tonsillectomy and adenoidectomy.

    Isolated failure to thrive in an infant caused by chronic hypoventilation due to hypertrophic adenoids and tonsils, has not been previously described. A 9 month-old infant presented with weight loss and mild clinical respiratory signs. Hypoxemia and CO2 retention, however, were documented by transcutaneous gas measurement, and ENT examination revealed enlarged tonsils and adenoids. adenoidectomy and tonsillectomy at 9 1/2 months of age completely reversed the patient's hypoventilation and growth pattern. While the exact mechanism of failure to thrive secondary to upper airway obstruction in infancy is not clear, we conclude that routine ENT evaluation should be a regular part of the workup of infants under one year who suffer from failure to thrive.
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ranking = 1
keywords = airway obstruction, obstruction, airway
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16/21. Unsuspected cardiopulmonary abnormalities complicating bronchopulmonary dysplasia.

    bronchopulmonary dysplasia is a serious chronic lung disease of infancy but despite numerous problems such as poor growth, recurrent lower respiratory tract infections, and cor pulmonale, steady improvement and recovery may generally be expected. We report four infants with bronchopulmonary dysplasia in whom the cardiopulmonary course did not show the usual steady improvement. Each infant was found to have an unsuspected cardiopulmonary lesion in addition to lung disease: two had congenital heart disease and two upper airway obstruction. Three improved after surgical intervention but one patient died immediately after this. Persistent right ventricular hypertrophy in patients with bronchopulmonary dysplasia maintained on supplemental oxygen, and a particularly slow rate of recovery from the need for supplemental oxygen are markers that should lead to evaluation for coexisting cardiopulmonary abnormalities.
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ranking = 1
keywords = airway obstruction, obstruction, airway
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17/21. Craniometaphyseal dysplasia as a rare cause of a severe neonatal nasal obstruction.

    We report on a 2-year-9-month-old boy with the typical features of craniometaphyseal dysplasia with hyperostosis and sclerosis of the cranial vault and mild splaying of the metaphyses. The boy already presented during the neonatal period with the unusual clinical picture of breathing and feeding problems due to severely enlarged and ossified inferior nasal conchae causing obstruction of the nasal lumen.
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ranking = 0.22285821751222
keywords = obstruction
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18/21. gastric outlet obstruction caused by prepyloric web in a case of Down's syndrome.

    The authors describe an infant with Down's syndrome who had a prepyloric web complicated by severe gastric outlet obstruction. The delay in diagnosis was responsible for malnutrition and the early postoperative complications of hypothermia and hypoglycemia. awareness of the association of gastrointestinal abnormalities with Down's syndrome will enable appropriate evaluation for early diagnosis of this surgically correctable malformation.
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ranking = 0.22285821751222
keywords = obstruction
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19/21. The Marshall-Smith syndrome: a review of the laryngeal complications.

    The Marshall-Smith syndrome is characterised by a triad of facial dysmorphism, failure to thrive and accelerated osseous maturation. We report a further case of this rare syndrome with the unusual but previously reported complication of laryngeal hypoplasia and review the associated laryngeal anomalies that have been reported to date. CONCLUSION: Severe airway obstruction due to congenital anomalies must be excluded in any dysmorphic child presenting with respiratory distress at birth. Rapid airway assessment will enable early and appropriate intervention and may be important when deciding on the long-term plan for the infant.
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ranking = 1.0260344373269
keywords = airway obstruction, obstruction, airway
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20/21. Marshall-Smith syndrome: the expanding phenotype.

    We report a child of 3 years 9 months with the Marshall-Smith syndrome (MSS), characterised by the typical facial features, developmental delay, and advanced bone age. After the diagnosis was made at 5 months of age, careful observation for respiratory complications and failure to thrive was initiated. By 3 1/2 years of age, although our patient had no life threatening respiratory complications, investigation showed significant upper airway obstruction, which has been successfully treated. Aggressive treatment for failure to thrive has also allowed her to maintain a weight on the 50th centile. The purpose of this report is to suggest that early diagnosis and aggressive management may improve the ultimate prognosis with respect to the respiratory and feeding difficulties seen in this rare syndrome.
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ranking = 1
keywords = airway obstruction, obstruction, airway
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