Prepyloric diaphragm, an unusual case of gastric outlet syndrome

The prepyloric diaphragm is a rare entity, with well-established anatomicopathological features but of unknown etiology. Approximately half of the 180 cases described occurred in children. The clinical presentation may be a chronic partial obstruction as in pyloric stenosis, or a complete gastric outlet obstruction when the orifice of the diaphragm is very small or nonexistent. Despite the variable clinical picture, radiological and endoscopic examinations may reveal typical pathognomonic features. With cases being reported more frequently, the treatment had changed from a wholly surgical approach to the introduction of endoscopic web incision and conservative treatment. We report a case diagnosis during surgery, and review the pertinent literature.