How Should the Pyloric Submucosal Mass Coexisting with Hypertrophic Pyloric Stenosis Be Treated?: A Case of Pyloric Ectopic Pancreas with Hypertrophic Pyloric Stenosis
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Co-existing pyloric submucosal masses with hypertrophic pyloric stenosis (HPS) are very rare and treating these lesions is always a problem. A 20-day-old boy presented with recurrent episodes of projectile non-bilious vomiting lasting for 5 days. HPS was suspected due to the presenting age and the symptoms. The sonography demonstrated not only circumferential wall thickening of the pylorus, but also a pyloric submucosal mass. At laparotomy, a 0.8 cm sized pyloric submucosal mass was identified along with a hypertrophied pylorus. Pyloric excision was performed due to the possibility of sustaining the symptoms and malignancy. The pathological report of the submucosal mass was ectopic pancreas. Coexisting pyloric lesions can be diagnosed along with HPS, and surgical excision, not just pyloromyotomy, should be considered in these circumstances. To the best of our knowledge, this is the first case report of pyloric ectopic pancreas and HPS to be diagnosed concurrently.
Abstract
Co-existing pyloric submucosal masses with hypertrophic pyloric stenosis (HPS) are very rare and treating these lesions is always a problem. A 20-day-old boy presented with recurrent episodes of projectile non-bilious vomiting lasting for 5 days. HPS was suspected due to the presenting age and the symptoms. The sonography demonstrated not only circumferential wall thickening of the pylorus, but also a pyloric submucosal mass. At laparotomy, a 0.8 cm sized pyloric submucosal mass was identified along with a hypertrophied pylorus. Pyloric excision was performed due to the possibility of sustaining the symptoms and malignancy. The pathological report of the submucosal mass was ectopic pancreas. Coexisting pyloric lesions can be diagnosed along with HPS, and surgical excision, not just pyloromyotomy, should be considered in these circumstances. To the best of our knowledge, this is the first case report of pyloric ectopic pancreas and HPS to be diagnosed concurrently.
참고문헌 (21)
- Chin AC, "Pyloric duplication with communication to the pancreas in a neonate simulating hypertrophic pyloric stenosis", J Pediatr Surg, 46, pp.1442~1444 (2011)
- Takeyama J, "Adenomyoma of the stomach mimicking infantile hypertrophic pyloric stenosis", J Pediatr Surg, 42, pp.E11~E12 (2007)
- Ozcan C, "A rare cause of gastric outlet obstruction in the newborn: Pyloric ectopic pancreas", J Pediatr Surg, 37, pp.119~120 (2002)
- Hishiki T, "A rare presentation in a case of gastric duplication cyst communicating to the pancreatic duct:coincidental detection during pyloromyotomy for hypertrophic pyloric stenosis", J Pediatr Surg, 43, pp.e1~e3 (2008)
- Kim S, "Coexisting hyperplastic antral polyp and hypertrophic pyloric stenosis", Pediatr Radiol, 27, pp.912~914 (1997)
- Murphy S, "Report of three gastric tumors in children", J Pediatr Surg, 29, pp.1202~1204 (1994)
- Chongsrisawat V, "Unusual manifestations of gastric inflammatory fibroid polyp in a child", World J Gastroenterol, 10, pp.460~462 (2004)
- Thompson WM, "Imaging characteristics of gastric lipomas in 16 adult and pediatric patients", AJR Am J Roentgenol, 181, pp.981~985 (2003)
- Iwasaki M, "Pyloric duplication cyst in an infant", Pediatr Int, 51, pp.146~149 (2009)
- Reggoug S, "Heterotopic pancreas: an unusual cause of epigastric pain", Gastroenterol Clin Biol, 34, pp.726~727 (2010)
- Mandell GA, "Association of antral diaphragms and hypertrophic pyloric stenosis", AJR Am J Roentgenol, 131, pp.203~206 (1978)
- Bell MJ, "Prepyloric gastric antral web: a puzzling epidemic", J Pediatr Surg, 13, pp.307~313 (1978)
- 이상엽, "소아에서 이소성 췌장을 동반한 위 중복낭종", 대한소화기학회지, 60(6), pp.391~393 (2012), 대한소화기학회
- 대한위암학회 정보전산위원회, "2005∼2006년 전국 위점막하종양 설문조사 결과 보고", Journal of Gastric Cancer, 8(2), pp.104~111 (2008), 대한위암학회
- Ogata H, "Heterotopic pancreas in children: review of the literature and report of 12 cases", Pediatr Surg Int, 24, pp.271~275 (2008)
- Christodoulidis G, "Heterotopic pancreas in the stomach: a case report and literature review", World J Gastroenterol, 13, pp.6098~6100 (2007)
- Ueno S, "Heterotopic pancreas as a rare cause of gastrointestinal hemorrhage in the newborn: report of a case", Surg Today, 23, pp.269~272 (1993)
- Tomita S, "Heterotopic pancreas-an unusual cause of melena in a pediatric patient", J Pediatr Surg, 44, pp.2432~2433 (2009)
- Malek MM, "Ashcraft's pediatric surgery", pp.605~615 (2010), Elsevier Saunders
- DeBord JR, "An unusual case of heterotopic pancreas of the stomach", Am J Surg, 141, pp.269~273 (1981)
- 주유민, "조기 위암에서 유문 보존 위절제술의 의의", Journal of Gastric Cancer, 6(1), pp.11~17 (2006), 대한위암학회