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Gastric outlet obstruction caused by prepyloric mucosal diaphragm mimicking duodenal ulcer: a case report
1Department of General and Pediatric Surgery, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.
Insights
A congenital antral web caused chronic gastric outlet obstruction in a child, initially misdiagnosed. Surgical excision of the web provided a long-term solution for this rare condition.
Area of Science:
- Pediatric Gastroenterology
- Surgical Innovation
- Diagnostic Challenges in Pediatrics
Background:
- Chronic gastric outlet obstruction presents diagnostic challenges in pediatric patients.
- Previous investigations, including upper gastrointestinal series and endoscopies, failed to identify the cause in this case.
- Delayed diagnosis can lead to prolonged symptoms and unnecessary medical interventions.
Abstract:
An 11-year-old child was evaluated for chronic gastric obstruction with intermittent symptoms from the age of 11 months. An upper gastrointestinal series performed at the age of 11 months was interpreted as compatible with severe pyloric stenosis due to a duodenal ulcer, but no surgery was recommended. Several other UGIT series, and at least four endoscopies performed during the following years by experienced gastroenterologists in Israel and in the United States, failed to reveal the true nature of the gastric outlet obstruction. The patient was operated upon shortly after referral to our institute. Upon celiotomy, a congenital antral web was found, the excision of which resulted in long-term relief of all symptoms. The differential diagnoses of childhood gastric outlet obstruction and the possible pitfalls in the diagnostic workup are discussed.