Endoscopy Challenge #2 - Jan '10

A 7 month old female, born at 29 weeks gestation, presented with 7 days of non bilious emesis and leakage of formula from her gastrostomy site

History:
A 7 month old female, born at 29 weeks gestation, presented with 7 days of non bilious emesis and leakage of formula from her gastrostomy site. There was no history of fever or diarrhea, and there were no sick contacts. The past medical history was notable for oropharyngeal discoordination necessitating gastrostomy feedings. There was no history of eczema or peripheral eosinophilia.

Her family history was negative for asthma, food allergic disease, and eczema.

On physical exam, pertinent findings included a full, but soft abdomen, which appeared to be tender to palpation without palpable mass. Her gastrostomy site had leakage around the tube from the stoma.

Diagnostic evaluation included upper GI contrast study revealing complete gastric outlet obstruction.


Upper GI endoscopy was performed revealing a hypertrophic pyloric mass protruding from the antrum into the gastric lumen.


Diagnosis

Discussion

References