A 9-year-old girl, 2nd child born out of non-consanguineous marriage with uneventful antenatal history, with a birth weight of 2.5 kg with no history of NICU admission was discharged on postnatal day 2. She was readmitted with frequent episodes of nonbilious vomiting and Jaundice on a postnatal day 3. She was diagnosed as a duodenal web. Duodeno-duodenostomy was done. She was found to have some dysmorphic facial features which were subtle. Noticeable one was a bifid thumb on the left hand.
See image 1 There were no significant malformations in the family. She was found to have abnormal cardiac findings on follow up, was investigated and found to have Ostium Secundum ASD 8mm size. She was breastfed, was attaining weight and her developmental milestones at par with her peers. At 4 years she had an episode of hematemesis. There were no other bleeding manifestations other than Malena…
