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Case report: Avoidant/restrictive food intake disorder after tonsillectomy

Gellan K Ahmed1,2, Ahmed A Karim3, Eman M Khedr1

  • 1Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt.

Frontiers in Psychiatry
|July 12, 2024
PubMed

Insights

Avoidant Restrictive Food Intake Disorder (ARFID) is a newly identified eating disorder. This case report details the first instance of ARFID in a child after tonsillectomy, highlighting potential surgical complications.

Area of Science:

  • Pediatric Gastroenterology
  • Child Psychology
  • Otorhinolaryngology

Background:

  • Avoidant Restrictive Food Intake Disorder (ARFID) is a recently classified eating disorder requiring further clinical understanding.
  • Oropharyngeal surgeries, such as tonsillectomy, may present unique challenges for pediatric patients.
  • Limited research exists on ARFID development following pediatric surgical interventions.

Observation:

  • A 10-year-old female presented with ARFID symptoms, including dysphagia for solids, vomiting, and food refusal, post-tonsillectomy.
  • The patient exhibited significant nutritional deficiency, dehydration, and comorbid anxiety and depression.
  • Initial misdiagnosis as myasthenic gravis underscores the complexity of ARFID presentation.

Findings:

  • This report documents the first pediatric case of ARFID occurring after a tonsillectomy.
  • The patient's symptoms suggest a potential link between oropharyngeal surgery and the onset of ARFID.
  • Delayed diagnosis and nutritional deficits highlight the severity of untreated ARFID.

Implications:

  • Pediatricians and surgeons should consider ARFID in children presenting with feeding difficulties post-tonsillectomy.
  • Early psychiatric evaluation is crucial for children experiencing ARFID symptoms after surgery.
  • Further research is needed to elucidate the pathophysiology of ARFID and its relationship to surgical procedures.
Abstract

Keywords:
avoidant/restrictive food intake disorderchild and adolescent psychiatry and psychotherapychildrencognitive-behavioural therapypsychopathologytonsillectomy

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