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[Interstitial gastric emphysema in children]
C Baeza-Herrera1, H M Nájera-Garduño, L M García-Cabello
1Departamento de Cirugía General, Hospital Pediátrico Moctezuma.
Insights
Gastric pneumatosis, a rare condition in children, is often linked to gastric emphysema. Pyloric obstruction is identified as a primary cause, with surgical intervention leading to survival in affected infants.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Surgical Pediatrics
Background:
- Gastric pneumatosis is an uncommon finding in pediatric patients, presenting as pneumatosis cystoides, emphysematous gastritis, or gastric emphysema.
- This condition requires careful diagnostic consideration due to its varied presentations.
Observation:
- The study describes four pediatric cases with interstitial gastric emphysema, identified through clinical and radiographic assessments.
- Two patients presented with hypertrophic pyloric stenosis, while the other two had unspecific erosive gastritis.
Findings:
- Interstitial gastric emphysema was suspected based on clinical course in all four patients.
- Two patients with hypertrophic pyloric stenosis underwent the Fredet-Ramstedt procedure.
- All four patients survived the condition, highlighting the importance of accurate diagnosis and treatment.
Implications:
- Pyloric and duodenal obstruction are identified as the principal etiologic factors in pediatric gastric emphysema.
- Correct radiological diagnosis and appropriate therapeutic interventions are crucial for successful patient outcomes.
- Understanding these associations aids in managing rare gastrointestinal emergencies in children.
Unlabelled:
Gastric pneumatosis is an unusual clinical finding in infants and children and it appears in the three following similar conditions: pneumatosis cystoides; emphysematous gastritis, and gastric emphysema. MATERIALS METHODS AND RESULTS: The clinical pictures and radiographic appearance of this association are described in four patients in whom the clinical course made suspect interstitial gastric emphysema. Two patients had hypertrophic pyloric stenosis and two, unspecific erosive gastritis. In the first two patients, a Fredet-Ramstedt procedure was performed. All patients survived. Differential diagnostic considerations, the importance of correct radiological diagnosis, and the results of proper therapy are discussed.
Conclusions:
Pyloric and duodenal obstruction in infants is the main etiologic factor in gastric emphysema.