Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Congenital Antral Web in Premature Baby

  • Nam, So-Hyun (Department of Pediatric Surgery, Inje University Haeundae Paik Hospital) ;
  • Koo, Soo Hyun (Department of Pediatrics, Inje University Haeundae Paik Hospital) ;
  • Chung, Mi Lim (Department of Pediatrics, Inje University Haeundae Paik Hospital) ;
  • Jung, Yu Jin (Department of Pediatrics, Inje University Haeundae Paik Hospital) ;
  • Lim, Yun-Jung (Department of Radiology, Inje University Haeundae Paik Hospital)
  • Received : 2012.12.26
  • Accepted : 2013.01.30
  • Published : 2013.03.30
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Abstract

Antral web is a rare cause of gastric outlet obstruction in neonate. It is a 2-4 mm thin mucous membrane that can be found anywhere from 1 to 7 cm proximal to the pylorus. The baby was born at gestational age of $32^{+1}$ weeks with 1,880 g as 2nd baby of dizygotic twin. After birth, the baby had constant non-bilious vomiting without feeding while he didn't show abdominal distension or discoloration. The infantogram showed distended stomach with distal small bowel gas. Upper gastrointestinal series revealed that the antrum was abruptly narrowed at 1 cm proximal to pylorus. We performed laparotomy at the 10th day after birth and excised the 2 mm-thick web circumferentially. He began milk feeding after 6 days and discharged uneventfully at postoperative 35 days with corrected age of $38^{+4}$ weeks with body weight 2,420 g. The antral web should be considered in the case of non-bilious vomiting in neonate.

Keywords

References

  1. Hait G, Esselstyn CB Jr, Rankin GB. Prepyloric mucosal diaphragm (antral web): report of a case and review of the literature. Arch Surg 1972;105:486-90. https://doi.org/10.1001/archsurg.1972.04180090089021
  2. Nissan A, Seror D, Udassin R. Gastric outlet obstruction caused by prepyloric mucosal diaphragm mimicking duodenal ulcer: a case report. Acta Paediatr 1997;86:116-8. https://doi.org/10.1111/j.1651-2227.1997.tb08845.x
  3. Gerber BC. Prepyloric diaphragm, an unusual abnormality. A case report. Arch Surg 1965;90:472-80. https://doi.org/10.1001/archsurg.1965.01320100016004
  4. Lui KW, Wong HF, Wan YL, Hung CF, Ng KK, Tseng JH. Antral web--a rare cause of vomiting in children. Pediatr Surg Int 2000;16:424-5. https://doi.org/10.1007/s003839900317
  5. Bell MJ, Ternberg JL, McAlister W, Keating JP, Tedesco FJ. Antral diaphragm--a cause of gastric outlet obstruction in infants and children. J Pediatr 1977;90:196-202. https://doi.org/10.1016/S0022-3476(77)80629-X
  6. Berr F, Rienmueller R, Sauerbruch T. Successful endoscopic transection of a partially obstructing antral diaphragm. Gastroenterology 1985;89:1147-51. https://doi.org/10.1016/0016-5085(85)90222-7
  7. Jung SE, Yu CS, Lee SC, Park KW, Kim WK. The surgical treatment for congenital gastric outlet obstruction. J Korean Surg Soc 1993;44:382-5.
  8. Jung J, Moon KR. A case of an antral web with a gastric ulcer due to ibuprofen. Korean J Pediatr Gastroenterol Nutr 2010;13:66-9. https://doi.org/10.5223/kjpgn.2010.13.1.66
  9. Choi KJ. Prepyloric gastric antral webs in children -report of two cases and review of the literature. J Korean Surg Soc 1988;35:610-4.
  10. Blazek FD, Boeckman CR. Prepyloric antral diaphragm: delays in treatment. J Pediatr Surg 1987;22:948-9. https://doi.org/10.1016/S0022-3468(87)80597-3
  11. Tiao MM, Ko SF, Hsieh CS, Ng SH, Liang CD, Sheen-Chen SM, et al. Antral web associated with distal antral hypertrophy and prepyloric stenosis mimicking hypertrophic pyloric stenosis. World J Gastroenterol 2005;11:609-11. https://doi.org/10.3748/wjg.v11.i4.609
  12. Anthony JP, Barbara JS. Digestive system disorders. In: Kliegman RM, Behrman RE, eds. Nelson textbook of pediatrics. 18th ed. Philadelphia: Elsevier Saunders, 2007:753.
  13. Medsinge A, Bartoletti SC, Furtado A, Katz A, Tadros SS. Isolated intramuscular fibrous band masquerading antral web in a premature neonate. A case report. J Pediatr Surg 2012;47:e17-9.

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