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An unusual cause of antro-pyloric stenosis in a child

Mario Mendoza-Sagaon, Flurim Hamitaga, Natalia Voumard, Karen Herreman-Suquet

Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland

 

Abstract 

After the neonatal period, diseases to induce gastric outlet obstruction in children are uncommon. We present the case of a 20 months-old girl with an unusual cause of antro-pyloric stenosis.
The girl was referred to our institution for hematemesis, melena, abdominal pain, post-prandial vomiting and epigastric distention following therapy with ibuprofen. An antro-pyloric ulcer was found as a cause of the stenosis and initially it was related to a probable peptic disease.
A laparoscopic Heineke-Mikulicz pyloroplasty was performed and antacid therapy was initiated. In the postoperative outcome, several endoscopies with balloon dilatations were needed to treat a recurrent pyloric stenosis.
Few months later a diagnosis of eosinophilic gastroenteritis was finally established and with the specific treatment the girl presented a better outcome and no more recidives of the stenosis occurred. Up to date, one year after the pyloroplasty, the girl is free of symptoms. The clinical presentation and therapy of this uncommon disease as a cause of gastric outlet obstruction is analyzed in this case report.