Malabsorption Disorder in Children: Clinical case and Viva Q&A

1. Clinical Case of Malabsorption Disorder in Children

A 2-year-old boy is brought to the pediatric clinic by his parents with complaints of chronic diarrhea, failure to thrive, and abdominal distension. The parents report the following:

• Loose, foul-smelling stools 3-4 times daily for the past 3 months
• Poor weight gain despite adequate caloric intake
• Increased irritability and decreased appetite
• Abdominal bloating that worsens after meals

Physical examination reveals:

• Weight: 3rd percentile for age
• Height: 10th percentile for age
• Distended abdomen with hyperactive bowel sounds
• Mild muscle wasting

Laboratory findings:

• Hemoglobin: 10.2 g/dL (low)
• Serum albumin: 2.8 g/dL (low)
• Serum ferritin: 8 ng/mL (low)
• Vitamin D: 15 ng/mL (deficient)
• Fecal fat: Increased
• Anti-tissue transglutaminase antibodies: Positive

Based on the clinical presentation, physical examination, and laboratory findings, the pediatrician suspects celiac disease as the underlying cause of malabsorption. An upper endoscopy with duodenal biopsy is performed, confirming the diagnosis of celiac disease. The child is started on a strict gluten-free diet, and nutritional supplementation is initiated.

2. Clinical Presentations of Malabsorption Disorders in Children

1. Celiac Disease:
   • Chronic diarrhea
   • Failure to thrive or weight loss
   • Abdominal distension and pain
   • Irritability and mood changes
   • Delayed puberty in adolescents
2. Cystic Fibrosis:
   • Recurrent respiratory infections
   • Failure to thrive
   • Greasy, foul-smelling stools (steatorrhea)
   • Salty-tasting skin
   • Nasal polyps
3. Lactose Intolerance:
   • Abdominal pain and bloating after consuming dairy products
   • Diarrhea
   • Nausea and sometimes vomiting
   • Excessive gas and flatulence
4. Short Bowel Syndrome:
   • Chronic diarrhea
   • Dehydration
   • Malnutrition and failure to thrive
   • Electrolyte imbalances
   • Vitamin and mineral deficiencies
5. Pancreatic Insufficiency:
   • Steatorrhea
   • Poor weight gain
   • Abdominal pain
   • Fat-soluble vitamin deficiencies (A, D, E, K)
6. Bile Acid Malabsorption:
   • Chronic watery diarrhea
   • Abdominal pain
   • Bloating
   • Fatty food intolerance
7. Giardiasis:
   • Acute or chronic diarrhea
   • Abdominal cramps
   • Bloating and excessive gas
   • Nausea
   • Weight loss
8. Cow's Milk Protein Allergy:
   • Diarrhea or constipation
   • Vomiting
   • Abdominal pain
   • Skin rashes (eczema)
   • Poor growth

VSD Quiz for Medical Students & Professionals

This interactive quiz component covers essential concepts about Ventricular Septal Defects (VSD) in pediatric cardiology. It includes 25 high-yield viva questions with detailed answers

Question 1 of 30

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