Gastric outlet obstruction caused by prepyloric mucosal diaphragm mimicking duodenal ulcer: a case report.
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.
Nissan
A
A
Department of General and Pediatric Surgery, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.
Seror
D
D
Udassin
R
R
D001466:Barium Sulfate; D002648:Child; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging / Q000601:surgery; D003287:Contrast Media; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004381:Duodenal Ulcer / Q000175:diagnosis; D017219:Gastric Outlet Obstruction / Q000209:etiology*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D011706:Pyloric Antrum / Q000002:abnormalities*; D011707:Pyloric Stenosis / Q000175:diagnosis; D011859:Radiography
D003287:Contrast Media; D001466:Barium Sulfate