• Anita Lamichhane, Rupesh Sharma, Ramana Rajkarnikar, Rubee Awale, Prapti Shrestha, and Nava Chandra Oli.
• Department of Pediatrics, Lumbini Medical College and Teaching Hospital, Pravas, Palpa, Nepal.
• JNMA J Nepal Med Assoc. 2020 Jul 31; 58 (228): 600-603.

AbstractVomiting with failure to thrive in older children is a diagnostic challenge due to the diversity in the diagnosis. We report a case of a five-years-old girl with failure to thrive, history of recurrent vomiting and intermittent colicky pain abdomen since 45 days of life. Intestinal malrotation with Ladd's band was diagnosed based on clinical acumen, high- resolution computed tomography, barium follow through and intraoperative findings. Exploratory laparotomy with Ladd's procedure was performed under general anesthesia which showed malrotation at the duodenojejunal junction with a short route of mesentery with floating caecum with Ladd's band. Failure to thrive with malrotation of the gut in the older age group is rare in itself. As there are very few cases reported in this age group, so we undertook to report this case to increase the awareness of knowledge concerning the diagnosis and timely management to prevent the comorbidity of this condition.

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