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Endoscopic diagnosis of duodenal stenosis in a 5-month-old male infant.

Nicholson MR, Acra SA, Chung DH, Rosen MJ - Clin Endosc (2014)

Bottom Line: Duodenal stenosis and duodenal atresia are well-known gastrointestinal anomalies in patients with Down syndrome.Although duodenal atresia presents early and classically with vomiting in the immediate neonatal period, the presentation of duodenal stenosis can be significantly more subtle and the diagnosis delayed.Here, we describe the case of a 5-month-old male infant with Down syndrome and delayed presentation of high-grade duodenal stenosis diagnosed endoscopically.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA.

ABSTRACT
Duodenal stenosis and duodenal atresia are well-known gastrointestinal anomalies in patients with Down syndrome. Although duodenal atresia presents early and classically with vomiting in the immediate neonatal period, the presentation of duodenal stenosis can be significantly more subtle and the diagnosis delayed. Here, we describe the case of a 5-month-old male infant with Down syndrome and delayed presentation of high-grade duodenal stenosis diagnosed endoscopically. Pediatric gastroenterologists should include duodenal stenosis in the differential diagnosis of older infants and children with vomiting and should be familiar with the endoscopic appearance of this lesion.

No MeSH data available.


Related in: MedlinePlus

Endoscopic images of congenital duodenal stenosis. (A) Duodenal bulb with an annular structure and no appreciable lumen. (B) Closer view of the villous mucosa in the center of the structure.
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Figure 1: Endoscopic images of congenital duodenal stenosis. (A) Duodenal bulb with an annular structure and no appreciable lumen. (B) Closer view of the villous mucosa in the center of the structure.

Mentions: On the day of admission, the patient underwent esophagogastroduodenoscopy using a GIF-XP 160 endoscope (Olympus, Tokyo, Japan). There was mild erythema in the distal esophagus, and a dark brown substance was observed in the stomach, consistent with blood exposed to gastric secretions. The duodenal bulb ended blindly (Fig. 1A), with a tubular structure containing normal-appearing villous mucosa in the center (Fig. 1B). No lumen could be identified in this structure.


Endoscopic diagnosis of duodenal stenosis in a 5-month-old male infant.

Nicholson MR, Acra SA, Chung DH, Rosen MJ - Clin Endosc (2014)

Endoscopic images of congenital duodenal stenosis. (A) Duodenal bulb with an annular structure and no appreciable lumen. (B) Closer view of the villous mucosa in the center of the structure.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4260107&req=5

Figure 1: Endoscopic images of congenital duodenal stenosis. (A) Duodenal bulb with an annular structure and no appreciable lumen. (B) Closer view of the villous mucosa in the center of the structure.
Mentions: On the day of admission, the patient underwent esophagogastroduodenoscopy using a GIF-XP 160 endoscope (Olympus, Tokyo, Japan). There was mild erythema in the distal esophagus, and a dark brown substance was observed in the stomach, consistent with blood exposed to gastric secretions. The duodenal bulb ended blindly (Fig. 1A), with a tubular structure containing normal-appearing villous mucosa in the center (Fig. 1B). No lumen could be identified in this structure.

Bottom Line: Duodenal stenosis and duodenal atresia are well-known gastrointestinal anomalies in patients with Down syndrome.Although duodenal atresia presents early and classically with vomiting in the immediate neonatal period, the presentation of duodenal stenosis can be significantly more subtle and the diagnosis delayed.Here, we describe the case of a 5-month-old male infant with Down syndrome and delayed presentation of high-grade duodenal stenosis diagnosed endoscopically.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA.

ABSTRACT
Duodenal stenosis and duodenal atresia are well-known gastrointestinal anomalies in patients with Down syndrome. Although duodenal atresia presents early and classically with vomiting in the immediate neonatal period, the presentation of duodenal stenosis can be significantly more subtle and the diagnosis delayed. Here, we describe the case of a 5-month-old male infant with Down syndrome and delayed presentation of high-grade duodenal stenosis diagnosed endoscopically. Pediatric gastroenterologists should include duodenal stenosis in the differential diagnosis of older infants and children with vomiting and should be familiar with the endoscopic appearance of this lesion.

No MeSH data available.


Related in: MedlinePlus