The unique relationship of the gastrointestinal system to the external environment and the nervous system can complicate the process of diagnosing intestinal pathology.
The clinician evaluating a child or adolescent with a complaint involving this system must determine if the etiology of the symptom is a result of the gastrointestinal (GI) system’s connection to other systems, or if the problem is confined to the GI tract. The case challenges in this issue represent a range of pathology, and demonstrate a variety of presentations and severity of disease. A common theme among the cases is the issue of weight change and its relative significance to the final diagnosis. The cases also illustrate how timing and referral to specialists can affect outcome. Primary care providers deal with these questions and concerns every day and hopefully, will find these cases and discussion helpful.
I am thankful to our contributing authors from the Divisions of Pediatric Gastroenterology and Nutrition at the University of Rochester Medical Center and State University of New York Upstate Medical University who eagerly shared their fascinating cases and expertise. I also thank William Herring, MD, of LearningRadiology.com and Donald Shaul, MD, for sharing their very illustrative images.