학술논문
A Classification for Gastric Outlet Obstruction in Childhood: Extending Beyond Infantile Hypertrophic Pyloric Stenosis
ORIGINAL ARTICLE PEDIATRIC GASTROENTEROLOGY
ORIGINAL ARTICLE PEDIATRIC GASTROENTEROLOGY
Document Type
Report
Author
Gurkan, Odul Egritas; Ozturk, Hakan; Kaya, Cem; Kaya, Neslihan Gurcan; Bozbulut, Neslihan Eksi; Can, Ayse; Ceylan, Kamercan; Aksu, Aysel Unlusoy; Duztas, Demet Teker; Sari, Sinan; Dalgic, Buket; Kapisiz, Alparslan; Coskun, Demet; Emmez, Gokcen; Inan, Gozde; Akdulum, Ismail; Pampal, Hasan Kutluk; Eryilmaz, Nuray Camgoz; Erel, Selin; Sivgin, Volkan; Yildirim, Ercan; Ermis, Okan; Gungor, Irfan; Kip, Gulay; Bedirli, Nurdan; Isik, Berrin; Ozen, Ibrahim Onur; Cavusoglu, Yusuf Hakan; Karabulut, Ramazan; Turkyilmaz, Zafer; Sonmez, Kaan
Source
The Turkish Journal of Gastroenterology. March 2024, Vol. 35 Issue 3, p255, 7 p.
Subject
Language
English
ISSN
1300-4948
Abstract
INTRODUCTION Gastric outlet obstruction (GOO) is a clinical syndrome comprising a broad spectrum of conditions that prevent the passage of gastric content into the duodenum. It is caused by mechanical [...]
Background/Aims: Gastric outlet obstruction (GOO) is a rare condition in childhood, with the exception of infantile hypertrophic pyloric stenosis (IHPS). However, no classification exists from a pediatric gastroenterologist's perspective. Materials and Methods: The patients with a diagnosis of GOO between 2009 and 2020 were reviewed retrospectively. We classified the patients according to GOO: presence of clinical findings accompanied by radiological and/or endoscopic findings; clinical status: intractable nonbilious postprandial vomiting alone or with abdominal pain, early satiety, weight loss, postprandial abdominal distension, and malnutrition; radiology: delayed gastric emptying and dilated stomach; endoscopy: nonbilious gastric contents after 6-8 hours of emptying and/or failed pyloric intubation; physical examination: visible gastric peristalsis. Results: A total of 30 GOO patients (15 patients with IHPS, 1 patient with annular pancreas, 4 patients with gastric volvulus, 2 patients with duodenal atresia, 2 patients with antral web, 1 patient with late-onset hypertrophic pyloric stenosis (LHPS) had surgical treatment, and remaining 5 patients had medical treatment) were enrolled to the study. The median age was 8 months (range: 3 months-16 years), and 14 patients were female. Mitochondrial disorders, LHPS, metabolic disorders, and eosinophilic gastrointestinal system diseases were added to Sharma's GOO classification, and the classification has been expanded. Conclusion: This is the first and largest study of GOO in children. From the perspective of pediatric gastroenterology, new diseases will be addressed, and definitions will be highlighted with our classification for GOO in childhood. Keywords: Gastric outlet obstruction, children, eosinophilic gastroenteritis, antral web
Background/Aims: Gastric outlet obstruction (GOO) is a rare condition in childhood, with the exception of infantile hypertrophic pyloric stenosis (IHPS). However, no classification exists from a pediatric gastroenterologist's perspective. Materials and Methods: The patients with a diagnosis of GOO between 2009 and 2020 were reviewed retrospectively. We classified the patients according to GOO: presence of clinical findings accompanied by radiological and/or endoscopic findings; clinical status: intractable nonbilious postprandial vomiting alone or with abdominal pain, early satiety, weight loss, postprandial abdominal distension, and malnutrition; radiology: delayed gastric emptying and dilated stomach; endoscopy: nonbilious gastric contents after 6-8 hours of emptying and/or failed pyloric intubation; physical examination: visible gastric peristalsis. Results: A total of 30 GOO patients (15 patients with IHPS, 1 patient with annular pancreas, 4 patients with gastric volvulus, 2 patients with duodenal atresia, 2 patients with antral web, 1 patient with late-onset hypertrophic pyloric stenosis (LHPS) had surgical treatment, and remaining 5 patients had medical treatment) were enrolled to the study. The median age was 8 months (range: 3 months-16 years), and 14 patients were female. Mitochondrial disorders, LHPS, metabolic disorders, and eosinophilic gastrointestinal system diseases were added to Sharma's GOO classification, and the classification has been expanded. Conclusion: This is the first and largest study of GOO in children. From the perspective of pediatric gastroenterology, new diseases will be addressed, and definitions will be highlighted with our classification for GOO in childhood. Keywords: Gastric outlet obstruction, children, eosinophilic gastroenteritis, antral web