We present a unique case of a prepyloric gastric muscular ring, a pathology distinct from a gastric web. There is scarcity of literature on this topic, nearly all cases of prepyloric antral rings or webs published in literature are mucosal or submucosal in nature with no evidence of muscle hypertrophy. Given the prevalence of pyloric stenosis as the most common gastric outlet malformation in neonates, gastric rings and webs are not readily considered in the differential diagnosis of gastric outlet obstruction. While most cases of gastric outlet obstruction are diagnosed radiologically, less common pathologies will be confirmed with direct visual inspection during surgery. The term "congenital gastric outlet obstruction" has been used to encompass rare cases, making it appropriate to include a muscular ring in this category. We propose the term "gastric ring" be used with a semantic modifier of "muscular" versus "submucosal/mucosal" to avoid confusion.
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http://dx.doi.org/10.1007/s12328-024-02010-0 | DOI Listing |
J Clin Med
December 2024
Gastroenterology and Gastrointestinal Endoscopy Division, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy.
Endoscopic ultrasound (EUS)-guided interventions have revolutionized the management of malignant biliary obstruction (MBO) and gastric outlet obstruction (GOO), providing minimally invasive alternatives with improved outcomes. These procedures have significantly reduced the need for high-risk surgical interventions or percutaneous alternatives and have provided effective palliative care for patients with advanced gastrointestinal and bilio-pancreatic malignancies. EUS-guided biliary drainage (EUS-BD) techniques, including hepaticogastrostomy (EUS-HGS), choledochoduodenostomy (EUS-CDS), and antegrade stenting (EUS-AS), offer high technical and clinical success rates, with a good safety profile particularly when Endoscopic Retrograde Cholangiopancreatography (ERCP) is not feasible.
View Article and Find Full Text PDFJ Clin Gastroenterol
January 2025
Division of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, WA.
Background And Aims: Gastric outlet obstruction (GOO) is a clinical manifestation of mechanical obstruction at the antropyloric region or proximal small bowel. The goal of endoscopic management is to relieve the obstruction so patients can resume per oral intake. Most studies have focused on malignant causes of GOO; yet only a handful have explored outcomes related to benign etiologies.
View Article and Find Full Text PDFWorld J Gastrointest Endosc
December 2024
Department of General, Gastroenterological and Oncological Surgery, Nicolaus Copernicus University, Toruń 87-100, Kujawsko-Pomorskie, Poland.
First of all, I would like to congratulate Vilas-Boas on an interesting publication. In this letter the authors write about very interesting topics in the management of patients with malignant gastric outlet obstruction (GOO). GOO developed in up to 20% of patients with advanced hepatopancreatobiliary disease both in benign and malignant form.
View Article and Find Full Text PDFCureus
November 2024
Pediatric Surgery, Nicklaus Children's Hospital, Miami, USA.
As the prevalence of childhood obesity continues to rise, there is an increase in demand for temporary and minimally invasive alternatives to bariatric surgery as solutions for addressing pediatric obesity. Intragastric balloon (IGB) placement is an increasingly popular methodology for addressing adult obesity; however, it is not approved for the pediatric population. We describe the case of a 17-year-old adolescent female who underwent IGB placement in Colombia and failed to receive proper follow-up care in the country of insertion resulting in a gastric outlet obstruction.
View Article and Find Full Text PDFCureus
November 2024
Internal Medicine, Allama Iqbal Medical College, Lahore, PAK.
Gastric outlet obstruction (GOO) is a clinical condition that can arise from both benign and malignant causes, requiring effective management strategies to ensure optimal patient outcomes. Traditionally, open surgical techniques like gastrojejunostomy (GJ) have been the standard treatment, but recent advances in minimally invasive procedures, such as endoscopic ultrasound-guided gastroenterostomy (EUS-GE), offer alternative approaches with potentially reduced morbidity. This systematic review compared the efficacy, safety, and clinical outcomes of endoscopic versus open surgical techniques in managing GOO.
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