Diagnosis of congenital antral web by ultrasound

Chew, Ai-Lean; Friedwald, J. P.; Donovan, Carolyn E.

doi:10.1007/bf02016251

Cited by 22 publications

(9 citation statements)

References 3 publications

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“…Air contrast study following administration of an anticholinergic agent to enhance delineation of the diaphragm 5 . Ultrasound has also been suggested as a diagnosis method 16 . Chew et al 16 proposed four ultrasound diagnostic criteria of an antral web, including demonstration of echogenic diaphragm-like structure localized at the antral region, gastric dilatation, delay in gastric emptying and a normal pylorus 16 ).…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasound has also been suggested as a diagnosis method 16 . Chew et al 16 proposed four ultrasound diagnostic criteria of an antral web, including demonstration of echogenic diaphragm-like structure localized at the antral region, gastric dilatation, delay in gastric emptying and a normal pylorus 16 ). Endoscopy remains a mainstay of diagnosis and the usual finding is the view of a persistent circular elevation of normal mucosa, demonstrating a pinpoint "psudopylorus" which is the evidence of the difficulty of the food to pass up to the duodenum 4 .…”

Section: Discussionmentioning

confidence: 99%

“…One explication for this is the loss of natural teeth and subsequent inadequacy of mastication causing mechanical difficulty and traumatic edema of the membrane which would lead to gastric outlet obstruction 25 . It also should be noted that complete antral diaphragm represents a form of gastric atresia is diagnosed within the first few days of life and incomplete atresia or antral web are diagnosed after the fifth decade of life, a pattern similar to congenital annular pancreas 13,16,23,26 .…”

Section: Discussionmentioning

confidence: 99%

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Antral mucosal diaphragm as a misdiagnosed cause of gastric outlet obstruction: case report and review of the literature

Bernardi¹,

Imakuma

Dantas

et al. 2015

Rev. Med. (São Paulo)

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The 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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Antral mucosal diaphragm as a misdiagnosed cause of gastric outlet obstruction: case report and review of the literature

Bernardi¹,

Imakuma

Dantas

et al. 2015

Rev. Med. (São Paulo)

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“…Upper gastrointestinal radiographic studies may be helpful and in fact several investigators claim that these studies are 90% accurate in the diagnosis of a gastric outlet obstruction, possibly an antral web 7. Recently, ultrasound has been shown to identify antral web when performed by a skilled operator and is advantageous due to the non-invasive nature of the study 8. In our case the diagnosis was suspected on a plain film and contrast studies, although the definitive diagnosis was not made until the pylorus was opened.…”

Section: Discussionmentioning

confidence: 99%

An asymptomatic presentation of gastric outlet obstruction secondary to congenital antral web in an extremely preterm infant

Godambe

Parvez²,

Ein³

2009

Case Reports

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A case of gastric outlet obstruction secondary to antral web in a preterm infant born at 25 weeks gestation is reported. The diagnosis was suspected on plain abdominal radiograph performed postnatally to confirm position of the umbilical catheters. On the initial radiograph (at age 1 h), a dilated stomach with a gasless abdomen was noted. A repeat chest and abdominal radiograph performed 24 h later due to increased ventilatory requirements showed persistence of this finding and upper gastrointestinal obstruction was suspected. An upper gastrointestinal contrast study confirmed the diagnosis of gastric outlet obstruction. The infant underwent a curative pyloroplasty on day 11 of life. The postoperative course was uneventful.

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“…Antral membranes may or may not obstruct the stomach. A membrane may appear on US as an echogenic band across the gastric antrum [16,17].…”

Section: Infantile Hypertrophic Pyloric Stenosismentioning

confidence: 99%

Ultrasound of the hollow gastrointestinal tract in children

Sj¹

1997

European Radiology

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IntroductionChildren are generally very suitable subjects for ultrasound (US) examinations. US is often the first investigation performed for suspected abdominal or pelvic pathology. It may precede radiographic examination and has many advantages. It is non-invasive, does not use ionising radiation and can be performed quickly and portably, if necessary. It is generally well tolerated by babies and children. Increasingly in paediatric practice US is used for investigating suspected disease of the hollow gastrointestinal (GI) tract. Improvements in US equipment, particularly the development of high-frequency linear-array transducers, have led to better visualisation of the GI tract by US. It is now possible to examine the bowel with transabdominal or transperineal US from the gastro-oesophageal junction to the rectum.Ultrasound, like other cross-sectional imaging techniques, primarily provides information about the bowel wall and masses related to the gut. Contrast studies and endoscopy are superior examinations for assessing the mucosa or lumen. However, unlike CT or MRI, US is also able to assess bowel motion. This may be particularly important in some paediatric GI conditions such as idiopathic hypertrophic pyloric stenosis, congenital gut dysmotility and Hirschprung's disease.The purpose of this review is to examine the current use of US of the hollow GI tract in children. Paediatric applications of newer developments in bowel US, such as endoscopic US and power-Doppler scanning, are also discussed. Normal bowelAll bowel has a similar wall composition comprising five concentric layers. These are the mucosa, deep mucosa, submucosa, muscularis propria (inner circular and outer longitudinal fibres) and the serosa or adventitia. Bowel wall constituents are visible on good-quality transabdominal US scans using high-frequency linear-array transducers.In adult patients high-quality images of bowel wall composition have been produced using endoscopic US [1]. It is possible to define the five layers of the bowel wall with this technique using frequencies of 7.5 and 12 MHz (Fig. 1). Transabdominal paediatric bowel US does not usually produce such clear internal detail of the gut wall (Fig. 2).There are no data in the literature on the normal range of US measurements of bowel wall thickness for children. Wall thickness is known to change with peristalsis. Published US measurements for bowel wall thickness in adults date from the early 1980's and are 3 and 5 mm for relaxed and contracted bowel, respectively [2]. Data are lacking on gut wall measurements in healthy children with modern US equipment. A recent study suggested that normal relaxed colon wall in children and adults was less than 0.8 mm thick [3]. TechniqueWe use 5-to 7-MHz curvilinear-array and 10.5-MHz linear-array transducers for paediatric bowel US. It is generally possible to use higher frequency US than in adult practice. These allow a study of both deep and superficial bowel loops. Fluid in bowel can facilitate the US examination. For example, administrat...

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Diagnosis of congenital antral web by ultrasound

Cited by 22 publications

References 3 publications

Antral mucosal diaphragm as a misdiagnosed cause of gastric outlet obstruction: case report and review of the literature

Antral mucosal diaphragm as a misdiagnosed cause of gastric outlet obstruction: case report and review of the literature

An asymptomatic presentation of gastric outlet obstruction secondary to congenital antral web in an extremely preterm infant

Ultrasound of the hollow gastrointestinal tract in children

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