Pseudo-Bartter Syndrome as an Atypical Presentation of Intestinal Malrotation: a Case Report

Abstract

Intestinal malrotation is a congenital intestinal rotation anomaly and can present with various symptoms. Pseudo-Bartter syndrome (PBS), which mimics the manifestations of Bartter’s syndrome, can be caused by a severe chloride deficiency and can be seen due to cystic fibrosis, hypertrophic pyloric stenosis, diuretic abuse, and so on. We presented a 3.5-month-old boy who had convulsion after multiple vomiting, followed up in the intensive care unit, and was diagnosed with malrotation. The patient complained of vomiting 10 times and diarrhea 3–4 times a day in the last 15 days. He went to another urban hospital after having a tonic–clonic seizure. Hypochloromic hypokalemic metabolic alkalosis was detected and he was admitted to the intensive care unit of our hospital. He was examined for differential diagnosis. The intestinal malrotation was diagnosed with esophagogastroduodenography. After surgery, he made a good recovery and was discharged symptom free. Cystic fibrosis, Barter syndrome, and hypertrophic pyloric stenosis are known diagnoses in patients presenting with PBS. Only two patients diagnosed with malrotation have been reported in the literature. We wanted to present this case so that the diagnosis of malrotation should be considered in patients presenting with PBS.