A two-year-old child who vomited after nearly every meal was successfully treated after doctors diagnosed a rare combination of situs inversus, a condition where internal organs are positioned as a mirror image of normal anatomy and a duodenal web, a congenital membrane that partially blocks the intestine.
According to a report by the Times of India, the toddler had been experiencing repeated vomiting, difficulty eating, and poor weight gain before doctors identified the underlying cause and treated the condition through specialized procedures.
The child, identified as Areeba Pasha, had symptoms that significantly affected her health and development.
As reported by the Times of India, she vomited after nearly every meal, which prevented her from maintaining proper nutrition and led to poor weight gain and general ill health.
Doctors later determined that two rare conditions were contributing to her symptoms:
Situs inversus, in which the internal organs are reversed in position.
Duodenal web, a congenital membrane that partially blocks the duodenum, the first part of the small intestine.
Doctors at a Mumbai hospital performed a two-stage endoscopic procedure to treat the obstruction caused by the duodenal web.
The medical team carefully navigated the unusual organ arrangement caused by situs inversus while removing the obstructing membrane.
Following treatment, the child’s digestive tract began functioning normally, allowing her to eat properly and improve her nutritional status.
One of the treating doctors told Times of India that the procedure required special attention due to the reversed anatomy.
Situs inversus is a rare congenital condition in which major internal organs are located on the opposite side of the body compared with typical anatomy.
For example:
The heart may point toward the right side of the chest (dextrocardia) instead of the left.
The liver may lie on the left side instead of the right.
The condition occurs in roughly 1 in 10,000 people and may sometimes be associated with other congenital anomalies affecting the heart or digestive system.2
Many people with situs inversus live normal lives and may remain unaware of the condition unless it is discovered during imaging or surgery.
A recent case reported by MedBound Times also discussed Catherine O’Hara, who had situs inversus with dextrocardia, illustrating how the condition can exist without causing significant health issues in some individuals.
A duodenal web is a rare congenital abnormality in which a thin membrane forms inside the duodenum, partially blocking the passage of food through the digestive tract.
The condition develops during fetal development when the duodenum fails to fully recanalize between the 8th and 10th weeks of gestation, leaving a membrane that obstructs the intestinal lumen.1
Depending on the size of the opening in the membrane, symptoms may appear early in infancy or later in childhood.
Common symptoms include:
Recurrent vomiting
Food intolerance
Abdominal distension
Poor weight gain or failure to thrive
Treatment usually involves surgical or endoscopic removal of the obstructing membrane to restore normal intestinal flow.
The coexistence of duodenal obstruction and situs inversus is uncommon.
Because organ positions are reversed, surgical or endoscopic procedures require careful planning and adaptation by medical teams.
After the procedure, the child was able to tolerate food normally and begin gaining weight, indicating that the intestinal blockage had been successfully relieved.
Doctors emphasized that early diagnosis and treatment of congenital intestinal obstruction are important to prevent complications such as malnutrition and developmental delays.
The case highlights how rare congenital conditions such as situs inversus and duodenal web can combine to cause digestive problems in children.
Timely diagnosis and specialized treatment allowed doctors to restore normal digestion in the toddler, improving her health and growth.
References
Ekram, Khesrow, Farida Razawi, Sayed Najmuddin Jalal, Mohammad Nader Sultani, Abdul Wali Wali, Mohammad Sharif Sediqi, Abdul Ghafar Hamdard, Massoud Hemat, and Mohammad Mustafa Sahibzada. “Congenital Duodenal Web Causing Partial Obstruction with Recurrent Vomiting and Abdominal Distention in a Toddler Boy: A Case Report.” Journal of Medical Case Reports 17 (2023): 507. https://doi.org/10.1186/s13256-023-04179-3.
Eitler, K., A. Bíbok, and G. Telkes. “Situs Inversus Totalis: A Clinical Review.” International Journal of General Medicine 15 (2022): 2437–2449. https://doi.org/10.2147/IJGM.S295444.
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