A 3 month old child with a normal birth history presented with failure to thrive, poor feeding and abdominal distension. Using an ultrasound and subsequent gastrointestinal study, the patient was eventually diagnosed with congenital short bowel syndrome, a common cause of failure to thrive. ^[1]

• A 3 month old girl presented with failure to thrive and abdominal distension.
• Despite a normal pregnancy and birth history, the child appeared severely malnourished (less than 1st percentile for weight and less than 10th percentile for height).

• On examination, the abdomen was soft and mildly distended with visible gut loops.
• An ultrasound revealed a duodenum-jejunal junction which was lower than it’s normal position.
• By moving the transducer along the course of the dilated loop (thereby, tracing the intestine from the duodenum to the colon) a dramatically short small intestine was revealed.
• Eventually a gastrointestinal study revealed a distended abdomen and intestine, malrotation and a short length of dilated small bowel.
• The patient was diagnosed with congenital short gut syndrome, a common cause of failure to thrive.

• The study underlined the utility of an ultrasound in diagnosing failure to thrive.
• By catching it early, early treatment, prevention of complications and genetic counselling was facilitated.