Content area
Full Text
SUMMARY: Lu J-P, Huang Y, Wu J, Chen S-Y. Uncommon congenital antral web misdiagnosed twice as a pyloric ulcer: successful treatment with endoscopic balloon dilatation. Turk J Pediatr 2014; 56: 100-102.
Congenital antral webs are quite rare and easily overlooked or misdiagnosed. We report the case of a five-year-old boy who presented with symptoms of gastric outlet obstruction for four years; his condition was misdiagnosed twice as pyloric ulcer. Detailed gastroscopy revealed a congenital antral web. The stricture was successfully treated with endoscopic balloon dilatation without surgery.
Key words: congenital antral web, endoscopic balloon dilatation.
Congenital antral web, first described in 1940 by Touroff et al.1, is a rare cause of prepyloric gastric outlet obstruction. This condition is present in approximately one in 100,000 births. Antral web is generally regarded as a congenital anomaly characterized by the presence of a circumferential mucosal septum that narrows the gastrointestinal lumen in the prepyloric region, with intraluminal projection perpendicular to the long axis of the antrum2.
This anomaly is quite rare and has received little medical attention. In most cases, the presenting symptoms are non-bilious vomiting and weight loss, sometimes accompanied by abdominal pain and cramping3. An atypical clinical manifestation can lead to misdiagnosis, and this condition often cannot be distinguished from gastric outlet diseases such as hypertrophic pyloric stenosis and peptic ulcer.
Here, we report the case of a five-year-old boy with a congenital antral web whose condition was misdiagnosed twice in other hospitals as pyloric ulcer. The stricture-related problems were successfully treated with endoscopic balloon dilatation (EBD) without the need for surgery.
Case Report
Our patient had a four-year history of recurrent non-bilious vomiting and hematemesis. At the age of 12 months, he was admitted to a local hospital due to these symptoms as well as hematochezia and iron deficiency anemia. At that time, he was diagnosed with a pyloric ulcer based on the endoscopic findings. The details of treatment were not recorded clearly. Four years later, non-bilious vomiting and hematemesis recurred, and the patient was admitted to another local hospital. Again, endoscopic examination led to the diagnosis of pyloric ulcer. No vomiting occurred during fasting, but this symptom recurred several hours later after the patent resumed eating, and it was accompanied by abdominal...