Gastroparesis associated with gastroptosis presenting as a lower abdominal bulking mass in a child: a case report

Abstract

BackgroundGastroparesis is defined as an inhibition of the gastric motility associated with delayed gastric emptying, which is mainly presented with acute dyspepsia. Gastroptosis is the downward displacement of the stomach.Case ReportWe report a rare case of secondary gastroparesis due to gastroptosis in an 11-year-old female child. The patient complained for bulking mass in the left lower quadrate presented a week ago, which was mimicking a large abdominal hernia. The laboratory and radiological exams revealed an excessive gastroptosis associated with gastroparesis. We searched the literature but we failed to find other cases with idiopathic gastroptosis in a child. The patient was treated conservatively and six months after the initial diagnosis and treatment the patient does not complains for dyspepsia.ConclusionGastroparesis associated with gastroptosis is a rare entity that can be treated conservatively with acceptable results.

The Clinical or Radiographic Diagnosis of Gastroptosis: Still Relevant?

“…Gastroptosis is diagnosed by the downward displacement of the stomach on an upper gastrointestinal (GI) study in a standing position, with the greater curve of the stomach partly projecting below the level of the iliac crests ( Figure 1). 1,2 The physiological position of the stomach varies between individuals, and also in one subject depending on many factors like stomach tone, the degree of fullness of the stomach, the position of the subject (supine or upright) and the strain of the abdominal muscles. 3 Gastroptosis may be associated with a variety of GI symptoms including epigastric pain or discomfort, early satiety and acid brash.…”

“…3 Gastroptosis may be associated with a variety of GI symptoms including epigastric pain or discomfort, early satiety and acid brash. [1][2][3][4] After a meal patients with gastroptosis may suffer from nausea and discomfort. 1 Gastroptosis is also associated with delayed gastric emptying.…”

“…[1][2][3][4] After a meal patients with gastroptosis may suffer from nausea and discomfort. 1 Gastroptosis is also associated with delayed gastric emptying. 1,3 Delayed gastric emptying, altered antroduodenal motility, and impaired gastric accommodation have been proposed to explain symptoms of functional dyspepsia.…”

“…1 Gastroptosis is also associated with delayed gastric emptying. 1,3 Delayed gastric emptying, altered antroduodenal motility, and impaired gastric accommodation have been proposed to explain symptoms of functional dyspepsia. [5][6][7][8][9] It is not known if gastroptosis itself leads to certain symptoms or if gastroptosis and related symptoms are the result of another disease.…”

“…10 Nowa-days only few cases have been reported in the literature. 1,3 In our university hospital, we recently were confronted with some children suffering from GI symptoms who had gastroptosis on the upper GI study, which brought this condition to our attention. Only small studies are available on gastroptosis, mostly on adults, and most of them are outdated.…”