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Gastroduodenal Emphysema with Portal Venous Air due to Congenital Duodenal Web in a Child: A Case Report and Review of Literature

Congenital duodenal web causing proximal duodenal obstruction leading to gastroduodenal emphysema is a very rare presentation in infancy. Due to persistent 
peristalsis against the duodenal membrane, there is progressive stretching of the duodenal web leading to windsock deformity. We describe a rar...

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Autores principales: Wettasinghe, Mihiri Chami, Rosairo, Shanthini, Kiriwattuduwa, Samantha, Wickramasinghe, Nuwan Darshana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6988673/
https://www.ncbi.nlm.nih.gov/pubmed/32015925
http://dx.doi.org/10.1155/2020/9897208
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author Wettasinghe, Mihiri Chami
Rosairo, Shanthini
Kiriwattuduwa, Samantha
Wickramasinghe, Nuwan Darshana
author_facet Wettasinghe, Mihiri Chami
Rosairo, Shanthini
Kiriwattuduwa, Samantha
Wickramasinghe, Nuwan Darshana
author_sort Wettasinghe, Mihiri Chami
collection PubMed
description Congenital duodenal web causing proximal duodenal obstruction leading to gastroduodenal emphysema is a very rare presentation in infancy. Due to persistent 
peristalsis against the duodenal membrane, there is progressive stretching of the duodenal web leading to windsock deformity. We describe a rare case of a child with gastroduodenal emphysema and portal venous air due to duodenal obstruction secondary to a duodenal web. An eighteen-month-old male child, who was under investigation for failure to thrive, presented with a history of persistent projectile vomiting and progressive abdominal distension for two days. The abdominal ultrasound scan revealed air within the portal vein and in the wall of the stomach. Plain X-ray abdomen confirmed the presence of gas in the gastric wall and in the proximal duodenal wall. Upper gastrointestinal contrast study revealed complete obstruction at the second part of the duodenum. The child underwent emergency laparotomy, which revealed a duodenal web as the cause of the duodenal obstruction. During the surgery, windsock deformity was noted. This case illustrates that although rare, proximal duodenal obstruction due to duodenal web may present in early childhood and that alarming imaging features such as gastric emphysema and portal venous air could be associated with benign conditions.
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spelling pubmed-69886732020-02-03 Gastroduodenal Emphysema with Portal Venous Air due to Congenital Duodenal Web in a Child: A Case Report and Review of Literature Wettasinghe, Mihiri Chami Rosairo, Shanthini Kiriwattuduwa, Samantha Wickramasinghe, Nuwan Darshana Case Rep Pediatr Case Report Congenital duodenal web causing proximal duodenal obstruction leading to gastroduodenal emphysema is a very rare presentation in infancy. Due to persistent 
peristalsis against the duodenal membrane, there is progressive stretching of the duodenal web leading to windsock deformity. We describe a rare case of a child with gastroduodenal emphysema and portal venous air due to duodenal obstruction secondary to a duodenal web. An eighteen-month-old male child, who was under investigation for failure to thrive, presented with a history of persistent projectile vomiting and progressive abdominal distension for two days. The abdominal ultrasound scan revealed air within the portal vein and in the wall of the stomach. Plain X-ray abdomen confirmed the presence of gas in the gastric wall and in the proximal duodenal wall. Upper gastrointestinal contrast study revealed complete obstruction at the second part of the duodenum. The child underwent emergency laparotomy, which revealed a duodenal web as the cause of the duodenal obstruction. During the surgery, windsock deformity was noted. This case illustrates that although rare, proximal duodenal obstruction due to duodenal web may present in early childhood and that alarming imaging features such as gastric emphysema and portal venous air could be associated with benign conditions. Hindawi 2020-01-17 /pmc/articles/PMC6988673/ /pubmed/32015925 http://dx.doi.org/10.1155/2020/9897208 Text en Copyright © 2020 Mihiri Chami Wettasinghe et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Wettasinghe, Mihiri Chami
Rosairo, Shanthini
Kiriwattuduwa, Samantha
Wickramasinghe, Nuwan Darshana
Gastroduodenal Emphysema with Portal Venous Air due to Congenital Duodenal Web in a Child: A Case Report and Review of Literature
title Gastroduodenal Emphysema with Portal Venous Air due to Congenital Duodenal Web in a Child: A Case Report and Review of Literature
title_full Gastroduodenal Emphysema with Portal Venous Air due to Congenital Duodenal Web in a Child: A Case Report and Review of Literature
title_fullStr Gastroduodenal Emphysema with Portal Venous Air due to Congenital Duodenal Web in a Child: A Case Report and Review of Literature
title_full_unstemmed Gastroduodenal Emphysema with Portal Venous Air due to Congenital Duodenal Web in a Child: A Case Report and Review of Literature
title_short Gastroduodenal Emphysema with Portal Venous Air due to Congenital Duodenal Web in a Child: A Case Report and Review of Literature
title_sort gastroduodenal emphysema with portal venous air due to congenital duodenal web in a child: a case report and review of literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6988673/
https://www.ncbi.nlm.nih.gov/pubmed/32015925
http://dx.doi.org/10.1155/2020/9897208
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