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Gastric ulcer presenting as gastroesophageal reflux and apnea in a term neonate
S Skinner1, M Naqvi, E K Biskinis
1Department of Medicine/Pediatrics, Maricopa Medical Center, Phoenix, Ariz., USA.
Insights
Gastroesophageal reflux and gastric ulcers are rare causes of apnea in full-term infants. This case highlights the importance of considering these conditions when diagnosing apnea in newborns.
Area of Science:
- Neonatology
- Pediatric Gastroenterology
Background:
- Apnea is common in premature infants but less frequent in full-term neonates.
- In full-term infants, apnea often indicates underlying clinical conditions like infection or metabolic disorders.
Observation:
- A full-term infant presented with apnea.
- Diagnostic tests revealed central apnea, significant gastroesophageal reflux, and a gastric ulcer.
Findings:
- The 6-channel pneumocardiogram confirmed central apnea and episodes of low esophageal pH (< 4).
- An upper gastrointestinal series verified gastroesophageal reflux and identified a small antral gastric ulcer.
Implications:
- Gastroesophageal reflux and gastric ulcers should be considered in the differential diagnosis of apnea in full-term infants.
- This case underscores the need for thorough investigation into less common etiologies of neonatal apnea.
Abstract:
Apnea in the neonatal period frequently is associated with prematurity. Full-term infants who develop apnea usually have associated clinical conditions such as infection, shock, metabolic disorders, neonatal abstinence syndrome, intracranial pathology, and gastroesophageal reflux. Gastric ulcer also is a rare phenomenon in the neonatal period. We describe a full-term infant presenting with apnea. Upon investigation, a 6-channel pneumocardiogram revealed central apnea and multiple episodes of low esophageal pH (< 4), which is suggestive of gastroesophageal reflux. This was confirmed by an upper gastrointestinal series. A small antral ulcer crater also was demonstrated. When assessing the etiology of apnea in a full-term infant, gastroesophageal reflux and gastric ulcer should be considered.