TY - JOUR T1 - Metabolic mayhem. The advantage of keeping your nose both in the books and in the nappy! JF - Archives of disease in childhood - Education & practice edition JO - Arch Dis Child Educ Pract Ed SP - 150 LP - 155 DO - 10.1136/archdischild-2019-318477 VL - 107 IS - 2 AU - Buthaina Buzakuk AU - Judith van der Voort Y1 - 2022/04/01 UR - http://ep.bmj.com/content/107/2/150.abstract N2 - This case presentation takes you on a journey of diagnostic hurdles, covering a common neonatal presentation: abdominal distention with failure to pass meconium, followed by a presentation in infancy with metabolic, renal and electrolyte abnormalities. The article provides a systematic approach to the different clinical problems, allowing interpretation of results, making differential diagnoses and deciding on investigations and management. ER -