Shah R, Belsha D, Thomas A, Alsweed A. High suspicion unveils Hidden pathology of pediatric gastrointestinal surgical cases misidentified as medical: Three case reports. World J Clin Pediatr 2025; 14(3): 104096 [DOI: 10.5409/wjcp.v14.i3.104096]
Corresponding Author of This Article
Rabia Shah, Specialist Pediatrician, Department of Pediatrics, American Hospital Dubai, Umm Hurrair Residence 5, Apartment 208, Street 2, Area Umm Hurrair 1, Dubai 440000, Dubai, United Arab Emirates. dr.rabyashah12@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Sep 9, 2025; 14(3): 104096 Published online Sep 9, 2025. doi: 10.5409/wjcp.v14.i3.104096
High suspicion unveils Hidden pathology of pediatric gastrointestinal surgical cases misidentified as medical: Three case reports
Rabia Shah, Dalia Belsha, Arun Thomas, Ahmad Alsweed
Rabia Shah, Dalia Belsha, Arun Thomas, Department of Pediatrics, American Hospital Dubai, Dubai 440000, Dubayy, United Arab Emirates
Ahmad Alsweed, Department of Pediatric Surgery, American Hospital Dubai, Dubai 440000, Dubayy, United Arab Emirates
Co-first authors: Rabia Shah and Dalia Belsha.
Author contributions: Shah R designed the report; Alsweed A and Belsha D collected the patients’ clinical data; Shah R and Thomas A analyzed the data and wrote the paper; All authors read and approved the final manuscript.
Informed consent statement: Consent was obtained from the patients’ parents, both verbally and in written form.
Conflict-of-interest statement: All authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rabia Shah, Specialist Pediatrician, Department of Pediatrics, American Hospital Dubai, Umm Hurrair Residence 5, Apartment 208, Street 2, Area Umm Hurrair 1, Dubai 440000, Dubai, United Arab Emirates. dr.rabyashah12@gmail.com
Received: January 2, 2025 Revised: March 5, 2025 Accepted: April 27, 2025 Published online: September 9, 2025 Processing time: 165 Days and 20.3 Hours
Abstract
BACKGROUND
Gastrointestinal diseases in young children are often anatomic or inflammatory in nature and can present with symptoms similar to those of Cow’s milk protein allergy (CMPA), complicating diagnosis. This case series highlights 3 pediatric patients initially misdiagnosed with CMPA, emphasizing the need for a thorough evaluation.
CASE SUMMARY
Case 1: A 3-year-old child with chronic abdominal distension and constipation was initially treated for CMPA and was later diagnosed with Hirschsprung disease through rectal biopsy. Surgical intervention involved a laparoscopic colostomy followed by a pull-through procedure, leading to a successful recovery. Case 2: A 2-month-old infant presented with greenish-yellow vomiting and abdominal distension. Initially misdiagnosed with CMPA, further investigation using barium studies revealed partial intestinal malrotation. The patient underwent a laparoscopic Ladd’s procedure and recovered well. Case 3: A 6-month-old infant with persistent vomiting and failure to thrive had been treated for CMPA. Detailed imaging studies indicated achalasia. The child underwent a Heller myotomy, which resulted in significant symptom improvement and weight gain
CONCLUSION
Thorough evaluation of gastrointestinal symptoms is necessary in children. A high suspicion for alternative diagnoses will prevent delays in accurate diagnosis and proper treatment, leading to improved outcomes.
Core Tip: This case series highlights the importance of differential diagnosis in pediatric gastrointestinal cases. In this case series, 3 pediatric patients were initially misdiagnosed with cow’s milk protein allergy, leading to a delay in timely and appropriate surgical interventions. A thorough evaluation and a high suspicion for alternative diagnoses, including Hirschsprung’s disease, intestinal malrotation, and achalasia, are crucial for improving patient outcomes for children.
