Janoud Omran, Moughdib Talal Abou, Nasser Majd Hamed, Fakher Obaida Abo, Saab Rani, Al-Halabi Houssain
Faculty of Medicine, Damascus University, Damascus, Syria.
Faculty of Medicine, Damascus University, Damascus, Syria.
Int J Surg Case Rep. 2025 Feb;127:110882. doi: 10.1016/j.ijscr.2025.110882. Epub 2025 Jan 14.
Congenital pyloric web or diaphragm are rare causes of Gastric Outlet Obstruction (GOO) after infancy, representing approximately 1 % of gastrointestinal obstructions. While it typically presents in the neonatal period with nonbilious vomiting, delayed diagnosis beyond infancy is exceptionally rare.
An 11-year-old girl with presented with one-month history of postprandial vomiting. Her medical history was unremarkable and clinical examination and laboratory investigations were normal. A barium meal X-ray revealed narrowing at the gastric outlet. Endoscopy showed severe pyloric narrowing with undigested food in the stomach. Due to the severity of the stenosis, the endoscope could not traverse and surgical intervention was required.
Pyloric webs and diaphragms are considered rare causes of congenital GOO. Confirmation of the diagnosis requires an upper contrast study or endoscopy. Gastric outlet obstruction can manifest with various symptoms. The clinical onset varies depending on the underlying cause. We conducted a systematic literature review of all case reports and series focused on GOO patients over 10 years old due to webs or diaphragms. The review reveals that symptoms are varied and may persist for years before diagnosis due to the rarity of these anomalies and their nonspecific presentations. This review highlights the importance of follow-up period after treatment due to the risk of recurrence.
This case emphasizes the importance of conducting endoscopy or abdominal X-rays with barium meals in evaluating persistent gastrointestinal symptoms, particularly in female patients.
先天性幽门蹼或隔膜是婴儿期后胃出口梗阻（GOO）的罕见原因，约占胃肠道梗阻的1%。虽然它通常在新生儿期表现为非胆汁性呕吐，但婴儿期后延迟诊断极为罕见。
一名11岁女孩，有餐后呕吐1个月的病史。她的病史无明显异常，临床检查和实验室检查均正常。钡餐X线检查显示胃出口狭窄。内镜检查显示严重的幽门狭窄，胃内有未消化的食物。由于狭窄严重，内镜无法通过，需要进行手术干预。
幽门蹼和隔膜被认为是先天性GOO的罕见原因。确诊需要进行上消化道造影检查或内镜检查。胃出口梗阻可表现为各种症状。临床发病取决于潜在病因。我们对所有聚焦于10岁以上因蹼或隔膜导致GOO患者的病例报告和系列进行了系统的文献综述。综述显示，由于这些异常情况罕见且表现不具特异性，症状多样，可能在诊断前持续数年。该综述强调了由于复发风险，治疗后随访期的重要性。
本病例强调了在内镜检查或腹部钡餐X线检查在评估持续性胃肠道症状中的重要性，尤其是在女性患者中。
