Thirty-two-month-old with multiple duodenal webs diagnosed after failed gastrojejunostomy exchange successfully...

Intestinal webs are either congenital or acquired. There are few reported cases of either chemotherapy or nonsteroidal anti-inflammatory medications leading to acquired intestinal webs in adults. There are limited descriptions of endoscopic interventions used for therapy of numerous duodenal webs in pediatrics. Here, we describe a 32-month-old patient undergoing chemotherapy who had multiple duodenal webs. The patient was diagnosed after failed gastrojejunostomy tube exchange via atypical contrast filling pattern and direct visualization with endoscopy. This patient likely has acquired duodenal webs from the combination of nonsteroidal anti-inflammatory drug containing chemotherapy treatment and repeated tube trauma. Treatment involved serial esophagogastroduodenoscopy with a combination of endoscopic therapy including balloon dilation and incisional therapy with insulated-tip knife and cautery scissors. The patient now tolerates G-tube feedings.