CLINICAL HISTORY.—This 2-day-old patient was admitted to Los Angeles Childrens Hospital with the chief complaint of vomiting. The vomiting began at 36 hours of age, was persistent, and contained bile. It was reported that meconium had been passed but the Farber test was not done.
The mother of the patient was 35 years old, gravida V, para IV, and was in good health. She did have the "flu" during the second and third months of her pregnancy. The patient was born spontaneously at 34 weeks gestation and weighed 2,450 gm (5 lb 6½ oz).
On physical examination, the infant was flaccid and slightly cyanotic. The cyanosis was not visible when oxygen was administered. The presence of epicanthal folds was suggested and Brushfield spots were present. Ear, nose, and throat findings were normal. The lungs were clear to auscultation. The heart had a normal sinus rhythm and no murmur was heard.