title: Congenital webs of the gastrointestinal tract: 20 years of experience from a pediatric care teaching hospital in taiwan.
abstract: BACKGROUND
  To classify and evaluate the clinical spectrum of congenital webs in the gastrointestinal (GI) tract, including clinical courses and related factors.
  
  
  METHODS
  A retrospective chart review was performed on 37 patients with congenital GI webs at a pediatric care teaching hospital in north Taiwan. All of the related parameters were collected and analyzed.
  
  
  RESULTS
  Twelve patients had gastric webs, 22 had duodenal webs, and three had jejunal webs. The mean time to diagnosis was 1576 days for gastric webs, 116 days for duodenal and 230 days for jejunal webs. There was a statistically significant difference between the gastric and duodenal groups (p = 0.001). The major symptom was vomiting (78%). Patients with duodenal webs had a high association with congenital anomalies (50%). The major anomalies included cardiac (27%) and GI anomalies (18%). Endoscopy was performed in 10 gastric cases, and all of them were noted to have positive findings, including a fixed nonfolded stenotic ring following a second gastric chamber and a real pylorus. All of the patients received surgery except for three with gastric webs, and no mortality was noted. The mean postoperative days of tolerated feeding was 6 for those with gastric webs, 10 for those with duodenal and 11 for those with jejunal webs.
  
  
  CONCLUSIONS
  The clinical course of gastrointestinal webs may be chronic or obscure. A delay from onset of symptoms to treatment may exist, especially in gastric webs. We suggest that prompt endoscopic confirmation and surgical intervention for these lesions, when suspected due to clinical and radiologic abnormalities, will decrease the morbidity of unexplained recurrent symptoms or signs of GI obstruction in these patients.
authors.affiliation: Department of Pediatrics, Keelung Hospital, Department of Health, Executive Yuan, Taiwan; Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Hsin-Hong
authors.initials: HH
authors.lastname: Lin
authors.forename: Hung-Chang
authors.initials: HC
authors.lastname: Lee
authors.forename: Chun-Yan
authors.initials: CY
authors.lastname: Yeung
authors.forename: Wai-Tao
authors.initials: WT
authors.lastname: Chan
authors.forename: Chuen-Bin
authors.initials: CB
authors.lastname: Jiang
authors.forename: Jin-Cherng
authors.initials: JC
authors.lastname: Sheu
authors.forename: Nien-Lu
authors.initials: NL
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004386:Duodenum / Q000002:abnormalities* / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007415:Intestinal Obstruction / Q000209:etiology; D007583:Jejunum / Q000002:abnormalities* / Q000601:surgery; D008297:Male; D013270:Stomach / Q000002:abnormalities* / Q000601:surgery