Thirty‐two‐month‐old with multiple duodenal webs diagnosed after failed gastrojejunostomy exchange successfully treated with combination endoscopic therapy

JPGN reports Pub Date : 2024-07-08 DOI:10.1002/jpr3.12107
Naomi E. B. Tjaden, Michael Acord, Jane Minturn, Myron Allukian, P. Mamula
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Abstract

Intestinal webs are either congenital or acquired. There are few reported cases of either chemotherapy or nonsteroidal anti‐inflammatory medications leading to acquired intestinal webs in adults. There are limited descriptions of endoscopic interventions used for therapy of numerous duodenal webs in pediatrics. Here, we describe a 32‐month‐old patient undergoing chemotherapy who had multiple duodenal webs. The patient was diagnosed after failed gastrojejunostomy tube exchange via atypical contrast filling pattern and direct visualization with endoscopy. This patient likely has acquired duodenal webs from the combination of nonsteroidal anti‐inflammatory drug containing chemotherapy treatment and repeated tube trauma. Treatment involved serial esophagogastroduodenoscopy with a combination of endoscopic therapy including balloon dilation and incisional therapy with insulated‐tip knife and cautery scissors. The patient now tolerates G‐tube feedings.
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胃空肠造口术换药失败后被诊断为多发性十二指肠蹼的三十二个月大婴儿成功接受了内窥镜联合疗法
肠网有先天性和后天性之分。化疗或非类固醇抗炎药物导致成人后天性肠网的病例报道很少。关于内窥镜干预治疗儿科十二指肠蹼的描述也很有限。在此,我们描述了一名正在接受化疗的 32 个月大的患者,她患有多发性十二指肠蹼。该患者是在胃空肠造口术换管失败后,通过非典型造影剂填充模式和内镜直视下确诊的。该患者很可能是在含有非甾体抗炎药物的化疗和反复管道创伤的共同作用下患上十二指肠蹼的。治疗方法包括连续进行食管胃十二指肠镜检查,结合内镜治疗(包括球囊扩张)以及使用绝缘刀和烧灼剪进行切开治疗。患者现在可以耐受胃管进食。
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