gastrins and Gastric-Outlet-Obstruction

A 38-year-old female presented with a 3-year history of postprandial abdominal pain, refractory nausea, vomiting and hematemesis. She appeared malnourished and her symptoms were refractory to previous treatment with acid-suppressive drugs, prokinetics and antiemetics. Her medical history was significant for a diagnosis of juvenile polyposis syndrome at the age of 14 resulting in a transverse colectomy, and a diagnosis of Crohn's disease in her residual colon at the age of 35 resulting in a total colectomy.. Physical examination, blood analysis, esophagogastroduodenoscopy with biopsy, abdominal endoscopic ultrasound, abdominal CT scan, MRI, 24 h urine analysis, MIBG scintigraphy, ocreotide scintigraphy, fluorodeoxyglucose-PET scan and genetic testing for defined polyposis syndromes (SMAD4, BMPR1A).. Juvenile polyposis syndrome with outlet obstruction of the stomach and excessive hypergastrinemia.. Continuous acid-suppressive therapy, prokinetic therapy and total parenteral nutrition. Repetitive endoscopic polypectomy (also known as debulking) was performed twice and was followed by gastrectomy with duodenoesophageal anastomosis.

Topics: Adult; Antacids; Endoscopy, Digestive System; Female; Gastrectomy; Gastric Outlet Obstruction; Gastrins; Humans; Intestinal Polyposis; Neoplastic Syndromes, Hereditary; Parenteral Nutrition

An infant presented with hematemesis and gastric outlet obstruction. Preoperative diagnosis of duodenal duplication cyst was based on a collaboration of radiological studies. At exploration the patient was found to have a gastric polyp that had intussuscepted into the duodenum leading to obstruction and hypergastrinemia secondary to gastric mucosa in the duodenal alkaline environment.

Topics: Gastric Outlet Obstruction; Gastrins; Hematemesis; Humans; Hyperplasia; Infant; Male; Polyps; Stomach Neoplasms