Neonatal segmental enteritis due to cow's milk allergy

Area of Science:

• Pediatric Gastroenterology
• Neonatal Surgery
• Allergy and Immunology

Background:

• Cow's milk protein allergy (CMPA) is a common condition in infants.
• CMPA symptoms can include diarrhea, vomiting, and rectal bleeding.
• CMPA can present atypically, mimicking serious surgical conditions like Hirschsprung's disease and malrotation.

Observation:

• A neonate experienced recurrent episodes of segmental enteritis.
• The infant's condition progressed to signs of peritonitis during the last episode.
• The neonate was exclusively fed formula, suggesting a potential link to cow's milk.

Findings:

• The neonate's symptoms dramatically improved upon elimination of cow's milk from the diet.
• This case highlights CMPA as a potential cause of surgical abdomen in neonates.
• Atypical presentations of CMPA require careful consideration in differential diagnosis.

Implications:

• CMPA should be considered in the differential diagnosis of neonates presenting with surgical abdomen and unusual symptoms.
• Early identification and dietary management of CMPA can prevent unnecessary surgical interventions.
• This case underscores the importance of a thorough dietary history in diagnosing infant feeding issues.