Pyloric atresia associated with Dieulafoy lesion and gastric dysmotility in a neonate

J Pediatr Surg. 2011 Oct;46(10):E19-23. doi: 10.1016/j.jpedsurg.2011.06.015.

Abstract

In this case study, we report a male infant with pyloric atresia, extreme gastric distension, and a caliber-persistent gastric artery (Dieulafoy lesion) with massive gastric bleeding. After a transverse pyloroplasty and endoscopic hemoclip application to the caliber-persistent gastric artery, very slow gastric emptying developed, which required repeated surgical interventions. Gastroduodenostomy failed to promote gastric emptying. The intraoperative and postmortem histologic examinations of the gastric wall revealed a loss of interstitial cells of Cajal, which possibly explains the extreme motility disorder.

Publication types

  • Case Reports

MeSH terms

  • Abnormalities, Multiple
  • Diseases in Twins*
  • Fatal Outcome
  • Gastric Outlet Obstruction / congenital*
  • Gastric Outlet Obstruction / surgery
  • Gastrointestinal Hemorrhage / congenital
  • Gastrointestinal Hemorrhage / etiology*
  • Gastroparesis / etiology*
  • Gastroparesis / surgery
  • Hematemesis / congenital
  • Hematemesis / etiology
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Interstitial Cells of Cajal / pathology*
  • Jejunostomy
  • Male
  • Methicillin-Resistant Staphylococcus aureus
  • Pylorus / abnormalities*
  • Reoperation
  • Respiratory Insufficiency / etiology
  • Splenic Artery / abnormalities*
  • Splenic Artery / surgery
  • Staphylococcal Infections / complications
  • Stomach / blood supply*
  • Vascular Malformations / complications
  • Vascular Malformations / surgery