CT Abdomen and Barium Meal suggestive of bowel malrotation Laparotomy done which diagnosis case as Annular Pancreas and duodenal obstruction release Investigation
Summary Case 1 Case 2 A 22 month-old boy presented with
weakness, easy fatigability
Failure to thrive, Vomiting
Past history for frequent episodes of vomiting
6 days old term presented with
history of vomiting since birth
with refusal to feed for 2 days
no bowel motion x 1 day.
Weight 2.85 kg ,dehydrated lethargic, hypoactive,
Outcome Case1 (Liddle syndrome) Case 2 (Annular Pancreas ) the diagnosis of Liddle syndromewas concluded It is an autosomal dominant form of hypertension characterised by hypokalemia and suppressed renin and aldosterone levels due to volume expansion He was started on Ameloride 5 mg daily and oral potassium. Since then he is showing remarkable improvement in his condition his wt;11.5kg and normalization of the blood pressure and serum potassium. The muscle power improved. the diagnosis of Annular Pancreas was concluded
Laparotomy done and duodenal obstruction release Since then he is showing remarkable improvement in his condition
Discharge home with good general condition
What are the most likely causes of Hypertension and hypokalemic metabolic alkalosis?
DD according to Aldosterone and Renin level ◘ Condition associated with high Aldosterone, high renin Renin secreting tumor Renal artery stenosis Bartter syndrome Gitelman syndrome ◘ Condition associated with high Aldosterone low renin Hyperaldosteronism (1ry) Adrenal carcinoma ◘