上海380例家庭聚集性感染Omicron变异株的儿童及其家属临床特征分析（英文翻译）

目的 分析亲子病房收治模式下,家庭聚集性感染Omicron变异株的儿童及其家属的临床特点及转归。 方法 回顾性收集上海市第六人民医院新型冠状病毒肺炎（coronavirus disease 2019,COVID-19）定点医院于2022年4月8日至5月10日收治确诊的感染Omicron变异株患儿190例及其家属190例的临床资料,进行分析总结。 结果 儿童组和成人组均以轻型为主,儿童组轻型比例高于成人组（P<0.05）;2组临床表现均以上呼吸道症状为主,儿童组发热、腹痛腹泻、喘息发生率高于成人组（P<0.05）,鼻塞流涕咳嗽、咽干咽痒咽痛发生率低于成人组（P<0.05）;成人组治疗连花清瘟颗粒/小儿豉翘清热颗粒、中药汤剂、重组人干扰素α2b喷雾剂、止咳化痰药、奈玛特韦/利托那韦片使用率均高于儿童组（P<0.05）;儿童组疫苗接种率（30.5%）较成人组（71.1%）低（P<0.001）,而儿童组严重急性呼吸综合征冠状病毒2（severe acute respiratory syndrome coronavirus 2,SARS-CoV-2）核酸阳性持续时间短于成人组（P<0.05）。2组临床轻型者SARS-CoV-2核酸阳性持续时间短于普通型者（P<0.05）。2组有基础疾病者SARS-CoV-2核酸阳性持续时间长于无基础疾病者（P<0.05）。 结论 家庭聚集性Omicron变异株感染儿童和成人的临床分型均以轻型为主。尽管儿童疫苗接种率较低,但在亲子病房收治模式中,疾病恢复较快,SARS-CoV-2核酸阳性持续时间短于成人。     

寄生虫病

070299167例小儿脑囊虫病临床分析/杨琼∥中国病原生物学杂志.-2006,1(5).-347,351070300儿童腹痛、腹泻人群中人芽囊原虫的检测:附28例分析/王玲…∥临床儿科杂志.-2006,24(11).-902~903070301粤北儿童与成人恙虫病临床特点对比分析/周杰…∥华夏医学.-2006,19(4).-641~643采用临床流行病学的方法,对76例儿童恙虫病与198例成人恙虫病进行临床资料比较分析。结果:儿童与成人恙虫病的发生均以男性多见,发病年龄儿童平均为9.6岁,成人平均为35.2岁;咳嗽、腹痛、呕吐、咽充血、腹水症状以及肺损害、贫血、中毒性脑病的发生率儿童组比成人组高,而…     

少年儿童抗中性粒细胞胞浆抗体相关原发性系统性血管炎的临床和病理特点

目的 回顾性总结并分析儿童抗中性粒细胞胞浆抗体(ANCA)相关原发性系统性血管炎(AASV)患者的临床和病理特点,并与成人原发AASV患者作比较,以提高对该类疾病的认识。方法 将原发AASV的儿童患者与同期成人原发AASV患者的临床和病理进行比较。结果 儿童组加例,占同期诊断的原发AASV患者的7．87％(20／254),与38例成人住院患者相比,儿童组中女性患者比例显著高于成人组(儿童组80％;成人组50％,P=0．047),二组在疾病组成和ANCA类型方面差异无显著性,均以显微镜下型多血管炎及P-ANCA／抗MPO抗体阳性为主。儿童组高血压出现者显著少于成人组(儿童组20％;成人组61％,P=0．005),二组在肾脏受累,肾外器官受累,实验室检查,肾脏活检病理表现,治疗方案,临床缓解率方面均无显著性差异。结论 儿童原发AASV患者并不罕见,其临床与病理特点与成人原发AASV基本一致,但女性患者更为常见。     

184例儿童与成人横纹肌肉瘤的比较研究

目的 比较分析儿童与成人横纹肌肉瘤的预后差别及其临床影响因素.方法 回顾性分析天津医科大学肿瘤医院1993年1月至2009年6月间经病理确诊为横纹肌肉瘤且有完整随访资料的184例患者,其中分为儿童组93例(≤18周岁)和成人组91例(＞18周岁).结果 1年、3年、5年生存率儿童组分别为90.3％、62.0％、43.1％,成人组分别为86.8％、35.1％、20.0％.两组间1年生存率差异无统计学意义(P=0.454),但3年(P=0.001)和5年(P=0.007)生存率成人组均低于儿童组,并且Kaplan-Meier生存曲线也提示成人组(中位生存期26.7个月)低于儿童组(中位生存期47.3个月),Log-rank检验两生存曲线差异有统计学意义(P=0.003).多因素分析显示组织学类型、原发部位和术后分组是儿童RMS预后的独立影响因素,组织学类型、原发肿瘤大小和术后分组是成人RMS预后的独立影响因素.x2检验显示儿童组与成人组在组织学类型(胚胎型:77.4％、27.5％；腺泡或多形性:22.6％、72.5％；P=0.000)、原发部位(预后好的部位:40.9％、22.0％；预后不好部位:59.1％、78.0％;P=0.006)和远处转移(无转移:87.1％、73.6％；有转移:12.9％、26.4％；P=0.021)因素的差异具有统计学意义.结论 成人RMS的预后明显差于儿童,组织学类型、原发部位和远处转移的差异是导致这种差别的可能因素.     

儿童原发性干燥综合征的临床特点

目的 探讨儿童发病的原发性干燥综合征(primary Sjogren’s Sydrome,pSS)临床特点,了解其与成人发病的pSS之间的差异。方法 回顾性分析我院门诊及住院诊治的pSS 421例,其中儿童发病者21例,成人发病者400例。结果 儿童组男2例,女19例,成人组男35例,女365例,两组间男女比例相似;成人发病者首发症状表现多样化,常见口眼干燥、关节疼痛、腮腺肿大、肾小管酸中毒等,儿童发病者首发症状以肾小管酸中毒、反复腮腺肿大、皮肤损害多见,未见肺部及神经系统明显受累;在整个发病过程中,儿童pSS肾小管酸中毒(52.4％)、皮疹紫癜(47.6％)均高于成人,而成人pSS的眼干燥(61.0％)和肺部病变(25.2%)则高于儿童(P均<0.01);实验室检查方面,儿童pSS类风湿因子(rheumatoid factor,RF)及γ球蛋白阳性率为100%,均高于成人pSS(p相似文献   

破骨细胞分化因子及其相关因子在儿童中耳胆脂瘤骨质破坏中的作用

目的 探讨破骨细胞分化因子(RANKL)和其配体核因子-κB受体活化因子(RANK)及假性受体骨保护素(OPG)即RANK-RANKL-OPG系统在儿童和成人中耳胆脂瘤骨质破坏中的作用.方法 选择4～14岁的中耳胆脂瘤患儿20耳(儿童组),以及18～60岁的中耳胆脂瘤患者20耳(成人组),应用免疫组织化学观察RANKL和OPG在儿童和成人胆脂瘤组织中的表达,对染色结果进行量化处理,并利用SPSS 11.0进行统计学分析.结果 1.RANKL阳性表达细胞数在儿童组和成人组中分别为(91.16±11.51)个、(80.33±12.72)个,二组比较差异有统计学意义(P=0.012);OPG阳性表达细胞数在儿童组和成人组中分别为(5.21±4.91)个、(5.66±3.76)个,二组比较差异无统计学意义(P=0.065);2.RANKL/OPG的比值在儿童组和成人组中分别为23.35±7.32、16.10±6.35,二组比较差异有统计学意义(P=0.009).3.胆脂瘤细胞的骨质破坏度和RANKL/OPG的比值呈正相关(rs=0.613 0,P<0.05).结论 RANKL可激活破骨细胞,在中耳胆脂瘤骨质破坏的机制中起重要作用;RANKL和OPG的比值在中耳胆脂瘤骨质破坏中是一个可靠的指标.     

多种酰基辅酶A脱氢酶缺乏症儿童与成人患者临床特点比较

目的比较儿童和成人多种酰基辅酶A脱氢酶缺乏症(MADD)患者的临床和实验室检查特点。方法对12例儿童和19例成人MADD患者进行常规实验室检查、血酰基肉碱谱及尿有机酸分析。对中国人电子转运黄素蛋白脱氢酶(ETFDH)基因常见突变A84T通过DNA测序方法进行筛检。结果儿童MADD患者临床表现高度异质,可表现为肌无力、肝大、低酮性低血糖、肥厚性心肌病或脑发育不良及脱髓鞘病变;而成人患者均以肌无力起病。成人和儿童MADD有肝酶和CK升高,血多种酰基肉碱升高,多数伴有二羧酸尿。儿童组3例死亡,成人组全部存活。存活患者的症状和生化指标治疗后好转或正常。A84T突变在儿童和成人患者的发生率分别为20.8%(5/24)和21%(8/38)。结论儿童与成人MADD患者的临床表现和预后存在差异,成人患者预后好;A84T突变可能与轻型相关。[临床儿科杂志,2012,30(5):446-449]     

小儿荨麻疹74例分析

荨麻疹为各种刺激因子所致以风团为特征的一种血管反应性皮肤病,可分急性、慢性两大类,儿童以急性多见。现将1989年10月～1991年8月二年中门诊诊治的74例小儿荨麻疹报道如下。临床资料     

扬州地区新型冠状病毒delta变异株感染54例儿童临床特点分析

目的 探讨儿童新型冠状病毒(SARS-CoV-2)delta变异株感染的临床特点及其与成人的异同点.方法 回顾性分析扬州市54例确诊SARS-CoV-2 delta变异株感染儿童的临床资料,并与同期确诊的青壮年成人患者比较.结果 儿童组54例,男35例、女19例,平均年龄(8.1±3.4)岁.成人组37例,男23例、女...     

儿童与成人气管切开术后拔管困难的临床分析

目的 探讨儿童与成人气管切开术后致拔管困难的病因、诊断、治疗以及提高拔管成功率的方法.方法 回顾性分析1990年1月至2006年10月我院收治的56例气管切开术后致拔管困难患者的临床资料.其中儿童组24例,年龄14个月～14岁,气管切开术后时间6个月～2年;成人组32例,年龄15～48岁,气管切开术后6个月～1.5年.结果 儿童与成人气管切开术后致拔管困难主要病因、诊断方法的选择及治疗过程中的特点、表现均存在不同.儿童气管切开术后致拔管困难主要发生在喉炎、气道异物致气道阻塞抢救性气管切开术后(14/24,58.33％),其次为头颈部外伤等急诊气管切开术(7/24,29.17％).成人气管切开术后拔管困难主要发生在喉部外伤所致的喉部病变(包括喉畸形、声门下狭窄或声带麻痹)(23/32,71.88％).儿童患者抗炎治疗组的平均堵管时间明显低于未抗炎治疗患者组(6.2d vs 10.1 d,t=4.26,P＜0.01).而成人患者抗炎治疗组与未抗炎治疗组的平均堵管时间比较差异无统计学意义(t=1.63,P＞0.05).在治疗过程中,儿童出现自觉呼吸困难的比率(21/21,100％)也明显高于成人组(13/28,46.43％).结论 3岁以下儿童应尽量避免气管切开术,3岁以上患儿气管切开术后能否成功拔管与年龄无确切相关.儿童患者首次治疗失败可能与炎症的存在有关;在治疗过程中应注意自觉呼吸困难发生的特点,儿童患者应选择无创性检查方法.重视心理因素对患者尤其是儿童的影响.     

Campylobacter upsaliensis gastroenteritis in childhood

BACKGROUND: Campylobacter upsaliensis can cause gastroenteritis and bacteremia. Data on its epidemiology and role in pediatric gastroenteritis are limited. OBJECTIVE: To describe the incidence and clinical features of enteric C. upsaliensis infection in children and to compare these with similar data for Campylobacter jejuni. DESIGN AND METHODS: Medical records of all patients with enteric C. upsaliensis infection between 1992 and 1999 at the Royal Children's Hospital, Melbourne, were reviewed. A case-control study (age-matched 1:2) was performed to compare the severity of clinical disease and associated risk factors for infection with C. upsaliensis and C. jejuni. RESULTS: Of 18,516 specimens 666 (3.6%) were positive for C. jejuni and 19 (0.1%) were positive for C. upsaliensis. Records were available for 18 patients with C. upsaliensis gastroenteritis (mean age, 1.6 years; median age, 1.3 years; range, 3 months to 7 years; 14 male). Eleven patients (61%) presented with acute and 7 (39%) with chronic or intermittent diarrhea. The case-control study showed that fever (P = 0.03), acute diarrhea (P = 0.05) and rectal bleeding (P = 0.0006) were significantly less common in C. upsaliensis than in C. jejuni infection. CONCLUSION: C. upsaliensis is a rare cause of gastroenteritis in young children and, compared with C. jejuni infection, is associated with significantly lower rates of fever, acute diarrhea and rectal bleeding.     

小儿迁延性、慢性腹泻病83例临床分析

目的 分析小儿迁延性、慢性腹泻病的病因、临床特点及治疗现状.方法 对2002年10月-2007年10月住院并诊断为迁延性、慢性腹泻病83例患儿的临床资料进行回顾性分析.结果 主要病因包括食物过敏29例(85.3%),乳糖不耐受61例(73.5%),免疫功能低下55例(66.3%),感染35例(42.2%)等.长时间腹泻患儿多伴有营养不良,不同程度的离子紊乱、微量元素缺乏、肠道菌群失调等,部分患儿合并其他脏器受累(如心肌、肝脏等).针对病因治疗,同时辅以支持疗法和对症治疗,取得了良好的效果.结论 迁延性、慢性腹泻的病因并不都是感染;其临床表现多样,并发症多;经不同途径联合治疗,可从各个不同环节阻断病情发展,减少并发症,从而缩短病程,提高治愈率.[临床儿科杂志,2009,27(10):930-934]     

有创机械通气重症肺炎患儿的临床特征及死亡危险因素分析

目的 探讨有创机械通气重症肺炎患儿的临床特征及死亡患儿的危险因素.方法 采用回顾性研究,收集2011年1月至2014年12月因需有创机械通气入住天津市儿童医院PICU的重症肺炎患儿资料,分析其年龄分布、病原学特点、机械通气情况、并发症及基础疾病情况,对死亡相关因素进行单因素分析及多因素分析.结果 共214例患儿符合标准纳入研究,其中男134例,女80例,总病死率6.17%.病原学检出率16.36%.死亡组患儿中位年龄大于生存组(4个月比2个月,P=0.039),年龄超过1岁患儿所占比例更高(21.43%比15.8%,P<0.001).脑病和电解质紊乱是有创机械通气重症肺炎患儿常见并发症,构成比分别为11.68%和8.41%.贫血、心脏病、呼吸系统发育异常位列基础疾病前3位(29.91%、14.49%、9.35%).Logistic多元回归分析显示,患儿发病年龄大于1岁(OR值1.019,95%CI 1.003~1.030,P=0.019),合并急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)(OR值7.254,95%CI 1.581~33.277,P=0.011),患有心脏病(OR值0.47,95%CI 0.273~0.810,P=0.007)是有创机械通气重症肺炎患儿死亡的危险因素. 结论 在救治需有创通气重症肺炎患儿时,对于年龄大于1岁、合并ARDS或患有心脏病的患儿要加强监护,积极治疗原发病,防治ARDS,必要时可行心脏手术以改善预后,降低需有创通气重症肺炎患儿的病死率.     

Daxx��NF-��B�ڶ�ͯ���԰�Ѫ���еı�Ｐ�������

目的探讨Daxx在儿童急性白血病(AL)骨髓细胞中的表达及其与NF-κB的相关性,同时观察其与AL临床分型和预后的关系。方法骨髓涂片取自华中科技大学同济医学院附属同济医院2005—2006年收治的AL患儿和骨髓正常的非恶性血液病患儿,应用免疫组织化学链霉素亲和素-生物素-过氧化酶复合物(SABC)方法检测50例儿童AL骨髓细胞Daxx和NF-κB的表达,对照组为20例非恶性血液病且骨髓正常患儿。结果在50例AL患儿中,Daxx和NF-κB蛋白阳性表达率分别为38.0%和56.0%,显著高于正常骨髓组织中的表达(P<0.05);Daxx与NF-κB表达呈强相关(P<0.05);急性淋巴细胞白血病(ALL)患儿高危组Daxx和NF-κB的表达率分别为55.6%和77.8%,标危组分别为0和16.7%,两组之间差异均有显著性(P<0.05)。结论Daxx、NF-κB在儿童AL中过度表达,在白血病细胞凋亡和增殖的调控过程中可能起协同作用,且与AL的某些临床特征、疗效和预后密切相关。     

Usefulness of random fecal alpha 1-antitrypsin and chymotrypsin determinations in children

Random fecal chymotrypsin activity and fecal alpha 1-antitrypsin (FA-1-AT) concentrations were determined in 11 children with cystic fibrosis, 5 children with Crohn's disease, 9 children with chronic aspecific diarrhea, 85 children with acute gastroenteritis, and 54 control children. Cystic fibrosis patients showed only very low fecal chymotrypsin values that did not overlap with values obtained in patients with either acute or chronic diarrhea. When compared with our control group, a significant increase of FA-1-AT concentrations was found only in children with Crohn's disease. Normal values were found in all patients with either chronic aspecific diarrhea or cystic fibrosis, while 12 of 85 children with acute gastroenteritis showed FA-1-AT concentrations above the 95th percentile of control children. We conclude that diarrhea (either acute or chronic) does not significantly decrease the clinical usefulness of fecal chymotrypsin activity measurements in the diagnosis of pancreatic insufficiency, while acute (gastroenteritis) but not chronic (chronic aspecific diarrhea, cystic fibrosis) diarrhea can give rise to protein losing and FA-1-AT concentrations similar to those found in Crohn's disease.     

Pediatric renal transplantation with mycophenolate mofetil immunosuppression in a single center from Mexico

An MMF-based immunosuppression has reduced the acute rejection rate in adults and in children in the early post-transplantation period. In the present study, pediatric renal transplantation patients on a CyA, MMF, and steroids regimen were prospectively evaluated. Patients with CyA, MMF, and steroid therapy without antibody induction were evaluated for surgical aspects, renal function, rejection, and survival, growth after transplantation, adverse events and medication discontinuation. Between February 2003 and May 2005, 21 kidney transplantation patients under 18 yr old were followed for at least 12 months. Within one year after transplantation, three patients developed four episodes of acute rejection (19%). Graft loss because of rejection occurred in one patient. One-year mean serum creatinine was 1.19 +/- 0.3 mg/dL. Mean calculated CrCl by Schwartz formula was 82.3 +/- 19.7 mL/min*1.73 m(2). Major adverse events included infections of the urinary tract and diarrhea, abdominal pain, and GI symptoms. No patients have discontinued the use of MMF. Good results in pediatric kidney transplantation can be achieved by using CyA/MMF/steroids. MMF is effective and relatively safe in reducing the incidence of acute rejection even without induction therapy 12 months after transplantation.     

Significant factors associated with severity and outcome of an initial episode of acute urticaria in children

Liu T‐H, Lin Y‐R, Yang K‐C, Tsai Y‐G, Fu Y‐C, Wu T‐K, Wu H‐P. Significant factors associated with severity and outcome of an initial episode of acute urticaria in children.
Pediatr Allergy Immunol 2010: 21: 1043–1051.
© 2010 John Wiley & Sons A/S The aim of this study was to determine the predictive factors of severity and duration of an initial episode of acute urticaria in children. This was a retrospective study of 1120 children of <18 yr who presented to the emergency department (ED) with an initial episode of acute urticaria during the period January 1, 2001, to December 31, 2007. These patients were followed in the ED or outpatient department (OPD) until their symptoms subsided. Variables comprising mild, moderate, and severe urticaria were compared to determine the predictors of severity. The relationships between duration of urticaria and clinical features, including physician‐diagnosed causes and treatment modalities, were also analyzed. Significant predictive factors of severity of an initial episode of acute urticaria in children included age, physician‐diagnosed causes of urticaria, clinical presentation, coexistent pyrexia or angioedema, and personal allergic history (all p < 0.001). The duration of urticaria was dependent on the physician‐diagnosed causes and treatment. Inhalants and unknown causes were predictive of longer duration, while contact materials were associated with shorter duration of urticaria (p < 0.001). Combination treatment comprising an oral plus injectable form of antihistamine or corticosteroid significantly shortened the duration of urticaria compared to single treatment (p < 0.001), especially in children receiving short‐term aggressive treatment in the pediatric observation unit (POU) of the ED.     

Urtikaria

Urticaria is divided in acute and chronic urticaria. Chronic urticaria lasts at least six weeks. Among this symptom one can separate at least the physical urticaria, urticaria with intolerance to aspirin or food additives, autoimmune urticaria beside chronic idiopathic urticaria. In children urticaria seems not to be as often as in adults, especially with regard to chronic urticaria. A frequency of about 5% of all urticaria patients is assumed to be younger than 16 years. About 7% of these patients are suffering from cold urticaria. Major progress in the understanding of the pathophysiology of urticaria has been achieved in recent years. Most important was the recognition of anti-FcεRIα autoantibodies in about 30% of patients with chronic urticaria. The first line drug for the treatment of most cases of urticaria are the antihistamines, demonstranting, that histamine is a major inflammatory compound which mediates urticaria. The development of antihistamines of the “3rd generation” such as ceterezine, fexofenadine, or levoceterezine provides us with safe drugs in this condition in which a longterm treatment may be needed.     

儿童抗生素相关性艰难梭菌腹泻的病例对照研究

摘要 目的：探讨儿童抗生素相关性腹泻（AAD）中艰难梭菌感染（CDI）的发生情况及临床特点,为抗生素相关CDI的诊治提供依据。方法：纳入2016年6月1日至2017年10月1日在复旦大学附属儿科医院行CD毒素A/B检测和CD厌氧培养且符合AAD诊断标准的住院患儿,排除＜1月龄、粪便常规细菌培养和病毒检测等临床信息不完整的病例,重复病例仅纳入首次诊断AAD时的临床信息。毒素A/B检测阳性或结肠镜检查提示假膜性肠炎者CDI组;余为非CDI组。单人从病志中采集一般资料,基础疾病,出现AAD相关腹泻症状前2个月内的抗生素使用情况,1个月内的治疗和药物使用情况,实验室指标等。结果：符合本文纳入标准的AAD患儿150例,年龄40 d至15岁2月,中位年龄1.4岁,男103例(68.7%)。CDI组24例（16.0%）,非CDI组126例。①CDI组急性腹泻22例（中位腹泻天数8 d）,因克罗恩病导致的慢性腹泻急性加重1例;因结肠息肉导致的迁延性腹泻急性加重1例,发热11例（45.8%）,呕吐8例（33.3%）,腹痛2例（8.3%）,腹胀1例（4.2%）;1例（1/5,20%）结肠镜显示为伪膜性肠炎。②CDI组和非CDI组发病年龄,性别,基础疾病,腹泻前2个月内抗生素应用情况,腹泻前1个月内手术或糖皮质激素、免疫抑制剂和抑酸药应用情况,实验室指标差异无统计学意义(P＞0.05)。多因素logistic分析显示CDI和非CDI临床表现和常规实验室检测指标差异无统计学意义(P＞0.05)。③AAD的主要治疗措施为停用广谱抗生素,益生菌辅助治疗,CDI患儿症状无好转时加用甲硝唑（应用5~7 d后未见明显好转改口服万古霉素）。CDI组腹泻均好转或痊愈,非CDI组117例（94.4%）腹泻症状好转,9例死于腹泻外的其他原因。结论：儿童AAD中 CDI发生率为16.0%,发热、呕吐为最常见的临床表现,经治疗后预后良好,仅凭临床表现和实验室检测指标不能区分儿童ADD中CDI和非CDI。     

Rare clinical presentation mode of intestinal malrotation after neonatal period: Malabsorption-like symptoms due to chronic midgut volvulus

BACKGROUND: Many different and non-specific clinic presentation modes of malrotation anomalies (MA) have been reported after neonatal period. The authors describe four children with MA presented with malabsorption-like clinical features. METHODS: Three children aged from 8 months to 7 years, with a history of long-standing diarrhea and failure to thrive attributed to malabsorption, were referred to Department of Pediatric Surgery, for evaluation of suspected MA. Another patient, a 10-year-old boy who was treated for malabsorption for 6 years, presented with acute duodenal obstruction findings. The duration of symptoms averaged 35 months, ranging 8 months to 6 years. All patients had undergone extensive evaluation and empiric trials of different formulas with no improvement in their symptoms. One underwent jejunal biopsy. RESULTS: Primary presentation complaints were chronic diarrhea and failure to thrive in three patients. Their histories revealed chronic (in one) and intermittent colicky (in two) abdominal pain, and intermittent nonbilious vomiting (in three). The remaining patient presented with acute illness, with chronic diarrhea, failure to thrive, and intermittent abdominal pain and vomiting on his history. They were below 30th percentile according to body weight and height. Laboratory studies revealed hypoproteinemia, hypoalbunemia, raised liver function tests, and anemia in all patients. The patient who presented acutely had double-bubble sign on the plain abdominal film obtained at admission. In the other three, plain films obtained during an attack of abdominal pain and/or vomiting revealed findings of partial intestinal obstruction. The diagnosis was confirmed by upper gastrointestinal series. At their laparotomy, a classical type of malrotation with circumstantial evidence of chronic volvulus was noted. All patients had normal laboratory values between postoperative 3 and 5 weeks, and they were up to 30th percentile at the end of the 6 months. CONCLUSIONS: Malrotation anomalies should be included in the differential diagnosis in a child presented with malabsorption-like clinical features.