Chronic obstruction of the stomach as a result of congenital malformation in a child of 1 year 10 months. Case report
- Authors: Schneider I.S.1,2, Tsap N.A.1,2, Gaydysheva E.V.2, Timoshinov M.Y.2, Ekimov M.N.2, Smirnova S.E.2
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Affiliations:
- Ural State Medical University
- Children’s City Clinical Hospital No. 9
- Issue: Vol 12, No 4 (2022)
- Pages: 513-520
- Section: Case reports
- URL: https://journals.rcsi.science/2219-4061/article/view/233298
- DOI: https://doi.org/10.17816/psaic1283
- ID: 233298
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Abstract
Congenital malformation of the gastrointestinal tract in a rare case can cause partial obstruction and masquerade as functional disorders of the intestine for a long time. Atypical clinic of membranous gastric obstruction causes difficulties in diagnosis and determination of treatment tactics. The aim — to determine and present to the surgical community the features of diagnosis, surgical treatment, possible complications of a rare malformation of the stomach in children in the form of a stomach membrane.
The paper presents a clinical case of the stomach membrane in a child 1 year 10 months old with complaints of vomiting after each meal, bloating, lethargy for one month. The results of ultrasonography, X-ray examination with the passage of a contrast agent through the gastrointestinal tract, fibrogastroduodenoscopy established anatomical changes in the stomach in the form of pyloric stenosis up to 0.4–0.5 cm in diameter. Intraoperative revision of the stomach, supplemented by intraluminal endoscopic support, made it possible to reliably establish the presence of a perforated pyloric membrane. The membrane is radically cut along the entire circumference at the level of its base. The next postoperative period was uneventful. After 1.5 months, the child was again admitted to the pediatric surgical department on an emergency basis with a clinic of intestinal obstruction, including the child’s anxiety, repeated vomiting, and bloating. X-ray and endoscopic picture corresponded to the diagnosis of cicatricial stenosis of the pyloric part of the stomach. Taking into account the presence of cicatricial deformity, due to the high risk of complications during resection of the stenotic part of the stomach and the imposition of gastroduodenoanastomosis, a bypass retrocolic gastrojejunoanastomosis with Brown fistula was formed. When examining a child of a child in the late postoperative period, no complications were identified.
The presented clinical case confirms that congenital malformations of the gastrointestinal tract in the form of stenoses and membranes can have a long stage of compensation, their diagnosis is based on a comprehensive examination of the child using radiopaque and endoscopic studies.
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##article.viewOnOriginalSite##About the authors
Inna S. Schneider
Ural State Medical University; Children’s City Clinical Hospital No. 9
Author for correspondence.
Email: inna-shnaider@mail.ru
ORCID iD: 0000-0001-9956-097X
SPIN-code: 8194-4541
Assistant of the Department, Pediatric Surgeon
Russian Federation, 3, Repina st., Yekaterinburg, 620028; YekaterinburgNatalya A. Tsap
Ural State Medical University; Children’s City Clinical Hospital No. 9
Email: tsapna-ekat@rambler.ru
ORCID iD: 0000-0001-9050-3629
SPIN-code: 7466-8731
Dr. Sci. (Med.), Professor
Russian Federation, Yekaterinburg; YekaterinburgElena V. Gaydysheva
Children’s City Clinical Hospital No. 9
Email: gaydesheva@gmail.com
ORCID iD: 0000-0003-3343-027X
SPIN-code: 7676-5350
Pediatric Surgeon
Russian Federation, YekaterinburgMaxim Yu. Timoshinov
Children’s City Clinical Hospital No. 9
Email: simashinov@gmail.com
ORCID iD: 0000-0002-6397-7156
SPIN-code: 6505-1442
Pediatric Surgeon
Russian Federation, YekaterinburgMikhail N. Ekimov
Children’s City Clinical Hospital No. 9
Email: malaj777@mail.ru
ORCID iD: 0000-0003-1802-6105
SPIN-code: 2872-7908
Pediatric Surgeon
Russian Federation, YekaterinburgSnezhana E. Smirnova
Children’s City Clinical Hospital No. 9
Email: snezhka-88@mail.ru
ORCID iD: 0000-0002-3257-5242
SPIN-code: 2489-4573
Pediatric Surgeon
Russian Federation, YekaterinburgReferences
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