Rare presentation of gastric antral web in a neonate: a case report

Gastric antral web (GAW) is a rare congenital anomaly in the distal stomach, which presents as a mucosal ring with an incidence of ⁓1-3 per 100 000 live births. Clinical presentation varies according to the web's size, ranging from minimal or no symptoms to postprandial vomiting in infants, to failure to thrive in children. We report a case of a 3-day-old female neonate admitted with recurrent, non-bilious vomiting and poor feeding tolerance. Physical examination was unremarkable aside from pallor, and laboratory results showed mild electrolyte imbalances. Imaging with a contrast study and ultrasonography revealed a 4 mm thick mucosal fold in the gastric antrum. Diagnosis of GAW was confirmed, the web was removed Heinick-Mikulicz pyloroplasty was performed. Pathology of removed specimen showed gastric pyloric mucosa, dilated elongated foveola and glands with patchy hemorrhages and no malignant changes. The patient was discharged with uneventful follow-up.