IMAGES IN EMERGENCY MEDICINE
An unusual case of neonatal ileus
1 Derby Hospitals NHS Foundation Trust, Derby, UK
2 Queen’s Medical Centre, Nottingham, UK
Correspondence to:
Dr P Cull, Emergency Department, Derby Hospitals NHS Foundation Trust, London Road, Derby DE1 2QY, UK; peter.cull@derbyhospitals.nhs.uk
Accepted 25 June 2008
| The first 150 words of the full text of this article appear below. |
A 2-week-old baby presented in northern Malawi with poor feeding from the age of 4 days, fevers, vomiting and increasing abdominal distension.
Omitted in the initial history was whether the baby had been fed dawale, a herbal infusion made from the roots of a tree species found in the area. This is fed directly to the infant, or added to porridge. It is given by grandmothers with the intention of protecting the child from disease. Paternal grandmothers significantly influence child feeding practices, and play a powerful role within the extended Malawian family structure.
Potential adverse consequences of dawale include ileus (fig 1) and sepsis. In the longer term, the early introduction of porridge and dawale has been shown to be associated with worse anthropometric status.1 A study of 12 cases of suspected paralytic ileus caused by traditional medicine in Malawi showed non-operative treatment to be effective in all
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