Antral mucosal diaphragm as a misdiagnosed cause of gastric outlet obstruction: case report and review of the literature
Palavras-chave:Antral web, Antral diaphragm, Surgery, Gastric surgery, Gastric outlet obstruction.
ResumoThe antral web is a thin septum with an aperture varying from 2 to 30 mm usually discovered in middle or late life because of associated gastric outlet obstruction or peptic ulcer. It is commonly mistaken for a pyloric obstruction. Since surgical excision of the antral diaphragm can cure patient’s symptoms, a correct diagnosis is important for not delaying treatment. However, the diagnosis is difficult even after adequate investigation with barium upper gastrointestinal x-ray series or endoscopy. Therefore, the present study seek to notify this pathology as a possible cause of gastric outlet obstruction providing an illustrative case report and review the pertinent literature. Case Report: A 56 years old man presented complaint of pyrosis, epigastric fullness after eating and loss of weight for over three years. His past clinical history revealed a perforated peptic ulcer surgery three years ago. Investigation was initially performed with barium upper gastrointestinal x-ray which suggested pyloric stenosis secondary to the previous surgery. Gastric endoscopy identified a mucous tunnel formation with a 10 mm diameter aperture in the pre-pyloric region. The patient was also submitted to a computerized tomography (CT) of the abdomen and pelvis for surgical planning for correction of pyloric stenosis and demonstrated an apparently thickening of the gastric wall and reduction of the diameter of the antropyloric region. The patient was then submitted to lapartomy with resection of the antral web. After 6 months, the patient is asymptomatic.
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Bernardi, M. D. C., Imakuma, E. S., Dantas, A. C. B., Freiberg, A. K., Lopasso, F. P., Zilberstein, B., & Cecconello, I. (2015). Antral mucosal diaphragm as a misdiagnosed cause of gastric outlet obstruction: case report and review of the literature. Revista De Medicina, 94(1), 15-20. https://doi.org/10.11606/issn.1679-9836.v94i1p15-20
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