Gastric Antral Web in a 103-Year-Old Patient

Gul, Waheed; Abbass, Khurram; Markert, Ronald J.; Barde, Christopher J.

doi:10.1155/2011/957060

Cited by 5 publications

(7 citation statements)

References 5 publications

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“…Whenever the stomach is normal but with gastric retention with an abrupt cutoff, and the pylorus and duodenal cap are normal, a GAW should be considered. EGD usually shows a large mucosal fold with a variable aperture or a pinpoint pseudopylorus as in our case causing diagnostic confusion [5,7].…”

Section: Letter To the Editormentioning

confidence: 74%

“…If GAW aperture is more than one centimeter and the patient is asymptomatic, only dietary modifications are advised [4][5][6]. In symptomatic patients or in smaller aperture, either surgical or endoscopic intervention is needed.…”

Section: Letter To the Editormentioning

confidence: 99%

“…The etiology of GAWs is agreed to be congenital in infants and children whereas in adults, whether it is congenital or acquired is controversial [4]. Approximately one fourth of all reported cases is associated with either gastric or duodenal ulcer disease, possibly caused by scarring of linear circumferential prepyloric and pyloric ulcers [4,5].…”

mentioning

confidence: 99%

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Gastric Outlet Obstruction

Mohammed

Benmousa²,

Almeghaiseeb³

et al. 2010

High-Yield Imaging: Gastrointestinal

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Section: Letter To the Editormentioning

confidence: 74%

Section: Letter To the Editormentioning

confidence: 99%

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Gastric Outlet Obstruction

Mohammed

Benmousa²,

Almeghaiseeb³

et al. 2010

High-Yield Imaging: Gastrointestinal

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“…GAW or antral mucosal diaphragm is a rare lesion reported in all ages, with an incidence of 0.14% in adults. 1,2 It consists of a layer of mucosa and submucosa lying perpendicular to the long axis of the stomach conjectured to occur during the healing of circumferential prepyloric ulcers.…”

Section: Discussionmentioning

confidence: 99%

Gastric Antral Webs: Anatomical Variants and Appropriate Endotherapy

Varadarajulu

Mohanasundaram

2020

Journal of Digestive Endoscopy

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AbstractWe report the case of a 65-year-old patient with rheumatoid arthritis presenting with dyspeptic symptoms. Upper gastrointestinal (UGI) endoscopy revealed a gastric antral web, which was confirmed by UGI series. The presence of webs in the gastrointestinal tract, excluding the esophagus, is a rarity. Here, we highlight the anatomical variations in antral webs and endoscopic diagnosis, which ultimately influence the type of endotherapy.

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“…Although such surgery successfully restored a functional gastric outlet and alleviated symptoms, an endoscopic “webotomy”, first suggested by Swartz and Shepard in 1956, heralded the minimally invasive options currently deemed safe given the lack of a muscularis propia in GAWs, and a low risk of perforation[14]. Endoscopic balloon dilation to 10 mm was first described in 1984, and has proven to be effective and safe to repeat[10,16]. However, frequent recurrence led to the development of more permanent interventions.…”

Section: Discussionmentioning

confidence: 99%

Gastric antral webs in adults: A case series characterizing their clinical presentation and management in the modern endoscopic era

Morales

Nigam

Chalhoub

et al. 2017

WJGE

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AIMTo investigate the current management of gastric antral webs (GAWs) among adults and identify optimal endoscopic and/or surgical management for these patients.METHODSWe reviewed our endoscopy database seeking to identify patients in whom a GAW was visualized among 24640 esophagogastroduodenoscopies (EGD) over a seven-year period (2006-2013) at a single tertiary care center. The diagnosis of GAW was suspected during EGD if aperture size of the antrum did not vary with peristalsis or if a “double bulb” sign was present on upper gastrointestinal series. Confirmation of the diagnosis was made by demonstrating a normal pylorus distal to the GAW.RESULTSWe identified 34 patients who met our inclusion criteria (incidence 0.14%). Of these, five patients presented with gastric outlet obstruction (GOO), four of whom underwent repeated sequential balloon dilations and/or needle-knife incisions with steroid injection for alleviation of GOO. The other 29 patients were incidentally found to have a non-obstructing GAW. Age at diagnosis ranged from 30-87 years. Non-obstructing GAWs are mostly incidental findings. The most frequently observed symptom prompting endoscopic work-up was refractory gastroesophageal reflux (n = 24, 70.6%) followed by abdominal pain (n = 11, 33.4%), nausea and vomiting (n = 9, 26.5%), dysphagia (n = 6, 17.6%), unexplained weight loss, (n = 4, 11.8%), early satiety (n = 4, 11.8%), and melena of unclear etiology (n = 3, 8.82%). Four of five GOO patients were treated with balloon dilation (n = 4), four-quadrant needle-knife incision (n = 3), and triamcinolone injection (n = 2). Three of these patients required repeat intervention. One patient had a significant complication of perforation after needle-knife incision.CONCLUSIONEndoscopic intervention for GAW using balloon dilation or needle-knife incision is generally safe and effective in relieving symptoms, however repeat treatment may be needed and a risk of perforation exists with thermal therapies.

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Gastric Antral Web in a 103-Year-Old Patient

Cited by 5 publications

References 5 publications

Gastric Outlet Obstruction

Gastric Outlet Obstruction

Gastric Antral Webs: Anatomical Variants and Appropriate Endotherapy

Gastric antral webs in adults: A case series characterizing their clinical presentation and management in the modern endoscopic era

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