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A 9-month-old boy was referred with a 6-month history of intermittent bilious vomiting, exacerbated after weaning onto solid food, and faltering growth. He had a diagnosis of trisomy 21, hypothyroidism and repaired congenital heart disease (atrioventricular septal defect and coarctation of the aorta). On examination, as well as typical features consistent with Down syndrome, his weight of 4910 g was below the third centile on an appropriate growth …
CGR and AMG contributed equally.
Contributors CGR and AMG made substantial contributions to conception of the article and revising it critically for important intellectual content. CB and HF gave final approval of the version to be submitted.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Patient consent for publication Parental/guardian consent obtained.
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