Pyloric atresia associated with Dieulafoy lesion and gastric dysmotility in a neonate.
In this case study, we report a male infant with pyloric atresia, extreme gastric distension, and a caliber-persistent gastric artery (Dieulafoy lesion) with massive gastric bleeding. After a transverse pyloroplasty and endoscopic hemoclip application to the caliber-persistent gastric artery, very slow gastric emptying developed, which required repeated surgical interventions. Gastroduodenostomy failed to promote gastric emptying. The intraoperative and postmortem histologic examinations of the gastric wall revealed a loss of interstitial cells of Cajal, which possibly explains the extreme motility disorder.
Department of Neonatology, Medical and Health Science Center, University of Debrecen, Hungary. pol07@freemail.hu
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E
Polonkai
Andrea
A
Nagy
István
I
Csízy
Csaba
C
Molnár
Tamás
T
Roszer
György
G
Balla
Tamás
T
Józsa
D000015:Abnormalities, Multiple; D004200:Diseases in Twins; D017809:Fatal Outcome; D017219:Gastric Outlet Obstruction / Q000151:congenital* / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000151:congenital / Q000209:etiology*; D018589:Gastroparesis / Q000209:etiology* / Q000601:surgery; D006396:Hematemesis / Q000151:congenital / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D056885:Interstitial Cells of Cajal / Q000473:pathology*; D007582:Jejunostomy; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D011708:Pylorus / Q000002:abnormalities*; D012086:Reoperation; D012131:Respiratory Insufficiency / Q000209:etiology; D013157:Splenic Artery / Q000002:abnormalities* / Q000601:surgery; D013203:Staphylococcal Infections / Q000150:complications; D013270:Stomach / Q000098:blood supply*; D054079:Vascular Malformations / Q000150:complications / Q000601:surgery