RT Book, Section
A1 Sun, Di
A1 Appachi, Elumalai
A2 Usatine, Richard P.
A2 Sabella, Camille
A2 Smith, Mindy Ann
A2 Mayeaux, E.J.
A2 Chumley, Heidi S.
A2 Appachi, Elumalai
SR Print(0)
ID 1114880628
T1 Down Syndrome
T2 The Color Atlas of Pediatrics
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-176701-9
LK accesspediatrics.mhmedical.com/content.aspx?aid=1114880628
RD 2024/04/19
AB A  2-day-old  baby  boy  is  brought  to  the  emergency  department  for  vomiting.  The  patient’s  mother  is  a  25  year-old  single  parent  who  did  not  receive  prenatal  care,  and  the  baby  was  born  at  home  via  vaginal  delivery  at  39  weeks  gestation.  The  mother  reports  that  the  baby  vomits  whenever  she  tries  to  breastfeed  him  and  that  the  emesis  appears  green  and  thick.  The  infant  is  noted  to  have  epicanthal  folds,  upward-slanting  palpebral  fissures,  flat  nasal  bridge,  a  single  transverse  palmar  (simian)  crease,  and  small  ears  (Figures  221-1  and  221-2).  The  examining  physician  suspects  the  child  has  Down  syndrome  and  orders  an  abdominal  x-ray,  which  reveals  a  “double-bubble,”  consistent  with  duodenal  atresia,  and  is  associated  with  Down  syndrome.  (Figure  221-3).  The  baby  undergoes  surgical  correction  of  the  atresia  and  recovers  completely.  A  chromosomal  analysis  confirms  the  diagnosis  of  Down  syndrome.