Related Experiment Video

Updated: Jul 4, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
07:44

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction

Published on: March 25, 2022

An unusual cause of gastric outlet obstruction during percutaneous endogastric feeding: a case report

Abdulzahra Hussain1, Hind Mahmood, Tarun Singhal

  • 1General Surgery Department, Princess Royal University Hospital, Kent, UK. azahrahussain@yahoo.com

Journal of Medical Case Reports
|June 13, 2008
PubMed

Insights

Lactobezoars, a rare cause of gastrointestinal obstruction in children on percutaneous endoscopic gastrostomy feeding, require surgical management. Early diagnosis via endoscopy is crucial for successful outcomes in pediatric acute abdomen cases.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Medical Imaging

Background:

  • Acute abdomen in children encompasses diverse pathologies, including rare gastrointestinal obstructions like bezoars.
  • Lactobezoars, concretions formed from milk formulas, can cause significant complications in children receiving prolonged enteral nutrition.
  • Management strategies for bezoars vary, necessitating a clear understanding of their presentation and treatment.

Purpose of the Study:

  • To report a rare case of lactobezoar formation in a pediatric patient with a percutaneous endoscopic gastrostomy (PEG) tube.
  • To emphasize the successful surgical management of lactobezoar-induced duodenal obstruction.
  • To highlight the importance of considering lactobezoars in the differential diagnosis of acute abdomen in children with PEG feeding.

Main Methods:

  • A 16-year-old boy presented with abdominal distension and high output from his PEG tube.
  • Clinical, radiological, and endoscopic evaluations revealed partial duodenal obstruction due to multiple gastric and duodenal bezoars.
  • Surgical intervention involved gastrojejunostomy after the removal of 14 lactobezoars.

Main Results:

  • The patient experienced a partial duodenal obstruction secondary to lactobezoars.
  • Successful surgical removal of 14 bezoars and gastrojejunostomy were performed.
  • The patient had an uneventful recovery and was discharged on postoperative day six.

Conclusions:

  • Lactobezoars are a critical consideration in the differential diagnosis of acute abdominal pain in pediatric patients with percutaneous endogastric feeding.
  • Endoscopic evaluation is vital for diagnosing lactobezoars and guiding the management of this upper gastrointestinal condition.
  • Prompt diagnosis and surgical intervention can lead to favorable outcomes in cases of lactobezoar-induced obstruction.
Abstract

Related Concept Videos

Pyloric Obstruction01:11

Pyloric Obstruction

Pyloric obstruction, also referred to as gastric outlet obstruction, is a condition characterized by narrowing or blockage at the pylorus—the muscular valve regulating the flow of stomach contents into the duodenum. When this passage becomes impaired, the stomach cannot effectively empty its contents into the small intestine. This disruption leads to a range of gastrointestinal symptoms, including early satiety, bloating, epigastric pain, postprandial nausea, persistent vomiting, and...
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding01:15

Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding

Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube through...
Enteral Nutrition I: Orogastric and Nasogastric Feeding01:26

Enteral Nutrition I: Orogastric and Nasogastric Feeding

Enteral nutrition delivers nutrients directly to the stomach or small intestine through a tube. This method is appropriate for patients who cannot eat but still have a functioning digestive system. It is also beneficial for individuals with swallowing difficulties, anorexia, malabsorption, or those who have undergone gastrointestinal (GI) surgery.
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

Endoscopic Procedures I: Esophagogastroduodenoscopy

An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...