Journal of Pediatric Surgery Case Reports (Mar 2024)

Gastric duplication complicated by hypergastrinemia: A case report

  • Kenki Yamagata,
  • Masaru Mizuno,
  • Mayako Morii,
  • Ryo Watanabe,
  • Chiaki Hatazawa,
  • Hiroaki Yoshino

Journal volume & issue
Vol. 102
p. 102778

Abstract

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Introduction: Gastrointestinal duplications are rare congenital anomalies that can occur anywhere throughout the intestinal tract. However, gastric duplication is very rare. A case of gastric duplication with uncommon complications, hypergastrinemia and duodenal ulcer, is described. Case report: The patient was an 11-year-old girl who presented with epigastric pain and non-bilious vomiting. The patient had a history of recurrent duodenal ulcers. Gastrin levels when the patient first presented with a duodenal ulcer at 8 years of age had reached 730 pg/mL. Computed tomography (CT) showed a cyst outside the pyloric antrum after remission of the duodenal ulcer, and it was suspected to be gastric duplication. For recurrence of the duodenal ulcer, the patient had been treated with histamine 2 receptor blockade for 3 years. At 11 years of age, the patient had stopped the medication and presented with gastric pain and vomiting. CT showed an enlarged gastric cyst and an obstructed pylorus. The patient was then referred to our hospital, and a laparotomy was performed to resect the cyst. Histological examination revealed positive staining for gastrin in the cyst wall mucosa, which is consistent with gastric duplication. Postoperative serum gastrin levels decreased, suggesting that gastric duplication had caused the hypergastrinemia. Conclusion: A case of gastric duplication was presented. Gastric duplication should be considered when treating patients with cystic disease of the pyloric region. In addition, hypergastrinemia may occur due to duplicated intestine near the pylorus, which may cause a duodenal ulcer.

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