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Open Access Highly Accessed Case report

An unusual cause of gastric outlet obstruction during percutaneous endogastric feeding: a case report

Abdulzahra Hussain*, Hind Mahmood, Tarun Singhal and Shamsi El-Hasani

Author Affiliations

General Surgery Department, Princess Royal University Hospital, Kent, UK

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Journal of Medical Case Reports 2008, 2:199  doi:10.1186/1752-1947-2-199

Published: 11 June 2008

Abstract

Introduction

The differential diagnoses of acute abdomen in children include common and rare pathologies. Within this list, different types of bezoars causing gastrointestinal obstruction have been reported in the literature and different methods of management have been described. The aim of this article is to highlight a rare presentation of lactobezoars following prolonged percutaneous endoscopic gastrostomy feeding and its successful surgical management.

Case presentation

A 16-year-old boy was admitted to a paediatric ward with abdominal distension and high output from his permanent gastrostomy feeding tube, with drainage of bilious fluids. The clinical, radiological and endoscopical examinations were suggestive of partial duodenal obstruction with multiple bezoars in the stomach and duodenum. Gastrojejunostomy was performed after the removal of 14 bezoars. The child had an uneventful postoperative course and was discharged on the sixth postoperative day in a stable condition.

Conclusion

Lactobezoars should be included in the differential diagnosis of acute abdominal pain in patients with percutaneous endogastric feeding. Endoscopy is important in making the diagnosis of this surgical condition of the upper gastrointestinal tract in a child.