QuestionSBA
QuestionChoice
This answer is incorrect. Whilst babies with Down's Syndrome are at increased risk of Hirschprung's disease, it typically presents with delayed passage of meconium after birth rather than vomiting.
10007488
c
Hirschprung's disease
QuestionChoice
This answer is correct. Babies with Down's Syndrome are at increased risk of pyloric stenosis. It presents with projectile vomiting and inadequate weight gain. The hypertrophied pylorus can sometimes be felt as a hard, olive-shaped lump on examination of the abdomen.
10007486
a
Pyloric stenosis
QuestionChoice
This answer is incorrect. Whilst babies with Down's Syndrome are at increased risk of duodenal atresia, it typically presents with projectile vomiting within the first 24-36 hours after birth. Projectile vomiting at 4 weeks, with a palpable abdominal mass, is more likely to be pyloric stenosis.
10007487
b
Duodenal atresia
QuestionChoice
This answer is incorrect. Whilst babies with Down's Syndrome are at increased risk of hypothyroidism, it does not present with vomiting, making this diagnosis unlikely.
10007490
e
Hypothyroidism
QuestionChoice
This answer is incorrect. Whilst babies with Down's Syndrome are at increased risk of GORD, the presence of a palpable abdominal mass and faltering growth make a diagnosis of pyloric stenosis more likely.
10007489
d
Gastroesophageal reflux disease (GORD)
Concept
Chapter
2693
4603
Down's Syndrome
Topic
153
Paediatrics
14044
A 4-week-old boy with Down's Syndrome is brought to children's A&E by his mother as she is concerned that he is projectile vomiting after all of his feeds and not gaining weight.

When his length and weight are plotted on a growth chart, it is noted that he has fallen by two centile lines.

On examination, a hard olive-sized lump is felt in the child's upper abdomen.

Which of the following conditions is the most likely cause of his vomiting?
a