Usual and unusual causes of pediatric gastric outlet obstruction

Abstract

Gastric outlet obstruction in children encompasses a spectrum of disorders that extends beyond hypertrophic pyloric stenosis. Each condition can result in the clinical syndrome of persistent nonbilious vomiting, which can progress to dehydration and electrolyte imbalances. This paper reviews the spectrum of both the common and uncommon entities that cause partial or complete gastric outlet obstruction and their imaging appearances. The correct diagnosis of those with gastric outlet obstruction can be achieved by combining clinical presentation with appropriate imaging, leading to optimal and timely patient management.

Food Allergy Mimicking Pylorus Hypertrophy

“…Other causes responsible for the symptoms have been described, including antral membrane, gastric volvulus, duplication cysts, polyps, intestinal malrotation, and neoplasms, though these are less frequent [1]. There are also reports in the literature of gastric outlet obstruction secondary to eosinophilic gastroenteritis (EG), consistent with our subject of interest.…”

“…The first successful surgical correction was performed by Ramstedt in 1912 [2]. The incidence in infants is variable, reported in 2-5:1000 live births in the United States [1]. In Africa and Asia, the incidence is lower, approximately 1:1000 live births [3].…”

“…The clinical history and a physical examination are essential for diagnosis. However, in order to define it, radiological images are usually needed [1].…”

Gastric Adenocarcinoma Presenting with Gastric Outlet Obstruction in a Child

“…Our patient is the first pediatric case to present with gastric outlet obstruction. Other differential diagnoses of gastric outlet obstruction that need to be considered include infectious cause (brucellosis, fungal infection, or tuberculosis), cicatricial gastric ulcer/duodenal ulcer, gastric bezoars, antral web, neoplastic lesions (lymphoma), and inflammatory lesions including Crohn's disease, eosinophilic gastritis, and chronic granulomatous disease [9]. …”

Pyloric adenomyoma: a rare cause of gastric outlet obstruction in childhood

“…2 Congenital hypertrophic pyloric stenosis is seen in 2e8 weeks-old newborns. 7 It presents as circumscribed and homogeneous pyloric hypertrophy of the muscularis propria up to four times its normal thickness with a gradual transition to the normal muscle coat. The mucosa looks unaltered.…”