Diagnosis and treatment of gastric antral webs in pediatric patients

Surgical Endoscopy
Ruchi AminMarjorie Arca

Abstract

Gastric antral webs are mucosal structures, varying from fenestrated diaphragms to mucosal crescents, resulting in varying degrees of foregut obstruction. Patients commonly present with vomiting, failure to thrive, and abdominal pain. Prevalence is unknown, and diagnosis can be difficult. We performed an IRB-approved retrospective review of patients from 4/1/2015-4/1/2018 at a Level I Children's Surgery Center undergoing gastric antral web resection. Data obtained included demographics, preoperative workup, surgical repair, and outcomes. Twenty-one patients were identified; 67% were male with an average age of 30 months at diagnosis. Initial diagnosis was established by a combination of fluoroscopy and esophagogastroduodenoscopy (EGD) in all patients. Patients presented with emesis (76%), failure to thrive (57%), need for post-pyloric tube feeds (33%), and abdominal pain (14%). Web localization without intraoperative EGD (n = 3) was initially challenging. As a result, intraoperative EGD was combined with operative antral web resection to facilitate web localization (n = 18). Web marking techniques have evolved from marking with suture (n = 1) and tattoo (n = 2), to endoscopic clip application (n = 12). All 21 patients underwent...Continue Reading

References

Jun 1, 1978·Journal of Pediatric Surgery·M J BellG D Shackelford
Jul 1, 1988·Gastrointestinal Endoscopy·F H Al-Kawas
Jun 9, 2004·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·C FergusonA Bianchi
Aug 21, 2013·Gastrointestinal Endoscopy·Wajeeh Salah, Todd H Baron
Jan 21, 2014·Journal of Pediatric Surgery·Marjorie J ArcaKeith T Oldham
Jan 20, 2017·World Journal of Gastrointestinal Endoscopy·Shannon J MoralesStanley B Benjamin

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Citations

Dec 20, 2019·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Katja KovacicMiguel Saps

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