Korean J Pediatr Gastroenterol Nutr.  2010 Mar;13(1):66-69. 10.5223/kjpgn.2010.13.1.66.

A Case of an Antral Web with a Gastric Ulcer due to Ibuprofen

• Jung J
• Moon KR

• KMID: 1459446
• DOI: http://doi.org/10.5223/kjpgn.2010.13.1.66

Abstract

An antral web is an extremely rare gastric anomaly that disturbs the gastric outlet. The onset of symptoms will depend on the diameter of the aperture. Obstructive symptoms may not occur when the aperture is >l centimeter in diameter. If the aperture is larger than 1 cm without significant symptoms, conservative treatment is sufficient. A case of an antral web with an ulcer and vomiting in a 7-year-old boy who received ibuprofen for 2 days is presented. The patient became symptom-free after medical treatment.

Keyword

Antral web; Gastric ulcer; Ibuprofen

MeSH Terms

Carbamates
Child
Humans
Ibuprofen
Organometallic Compounds
Stomach Ulcer
Ulcer
Vomiting
Carbamates
Ibuprofen
Organometallic Compounds

Figure

• 

  Fig. 1 UGI series shows a stricture at the antral portion and an ulcer crater with regular radiating mucosal folds (arrow).

• 

  Fig. 2 Gastroscopic finding. (A) Initially, an ulcer, erosion, and mucosal swelling around the antral web were noticed. (B) The normal pylorus can be seen through the aperture of the antral web.

• 

  Fig. 3 Seven days later, (A) the size of the ulcer was decreased and the radiating mucosal folds on the antral web were prominent. (B) Two months later, the ulcer was not visible and the antral web with an aperture diameter of 1.4 cm is shown.

Reference

1. Noel RJ, Glock MS, Pranikoff T, Hill ID. Nonobstructive antral web: An unusual cause of excessive crying in an infant. J Pediatr Gastroenterol Nutr. 2000. 31:439–441.

2. Kim YJ. A case of antral web in a child. Korean J Gastrointest Endosc. 1996. 16:761–764.

3. Choi KJ. Prepyloric gastric antral webs in Children. J Korean Surg Soc. 1988. 35:610–614.

4. Haddad V, Macon WL 4th, Islami MH. Mucosal diaphragms of the gastric antrum in adults. Surg Gynecol Obstet. 1981. 152:227–233.

5. Feliciano DV, van Heerden JA. Pyloric antral mucosal webs. Mayo Clin Proc. 1977. 52:650–653.

6. Blazek FD, Boeckman CR. Prepyloric antral diaphragm: delays in treatment. J Pediatr Surg. 1987. 22:948–949.

7. Bell MJ, Ternberg JL, McAlister W, Keating JP, Tedesco FJ. Antral diaphragm a cause of gastric outlet obstruction in infants and children. J Pediatr. 1977. 90:196–202.

8. Lu CC, Schulze-Delrieu K. Pyloric deformation from peptic disease. Radiographic evidence for incompetence rather than obstruction. Dig Dis Sci. 1990. 35:1459–1467.

9. Johnson GM. Gastric mucosal diaphragm in a child. Pediatrics. 1971. 47:916–919.

10. Gerber BC. Prepyloric diaphragm, an unusual abnormality. a case report. Arch Surg. 1965. 90:472–480.

11. Jinkins JR, Ball TI, Clements JL Jr, Elmer RA, Weens HS. Antral mucosal diaphragms in infants and children. Pediatr Radiol. 1980. 9:69–72.

12. Hait G, Esselstyn CB Jr, Rankin GB. Prepyloric mucosal diaphragm (antral web): report of a case and review of the literature. Arch Surg. 1972. 105:486–490.

13. Gross KE, Durham MW. Pyloric antral mucosal diaphragm; report of a case. Radiology. 1953. 61:368–372.

14. Banks PA, Waye JD. The gastroscopic appearance of antral web. Gastrointest Endosc. 1969. 15:228–229.

15. Skibba JL, Wesenberg RL, Anderson AD. Incomplete antral membrane in an infant. Am J Dis Child. 1973. 126:82–84.

16. Travis RC. Gastric antral webs in adults. Australas Radiol. 1990. 34:266–267.

17. Berr F, Rienmueller R, Sauerbruch T. Successful endoscopic transection of a partially obstructing antral diaphragm. Gastroenterology. 1985. 89:1147–1151.