Clinical History.—A 14-month-old girl was referred to our care with a history of recurrent bouts of diarrhea. Past medical history was negative except for the diarrhea. This proved to be due to food allergies and was controlled for approximately one year. It then reappeared and this prompted referral to our hospital.
Physical Examination.—Physical examination results were normal except for diminished breath sounds on the right side of the chest. This was an unexpected finding, and chest roentgenograms were obtained (Fig 1, left and right).
Clinical Course.—Food allergies were again established as the cause of the child's diarrhea, and treatment consisted of dietary adjustments. The chest roentgenogram, however, was abnormal and this with the physical findings focused attention on the cardiopulmonary system, even though the patient was asymptomatic in this regard. With further assessment and reevaluation, a judgment was finally made and, four months later, the child was