Korean J Pediatr Gastroenterol Nutr.  2011 Dec;14(4):398-402. 10.5223/kjpgn.2011.14.4.398.

A Case of Neonatal Gastric Ulcer with Large Hematoma Presenting as Gastric Outlet Obstruction

• Kim JS
• Shim EJ
• Lee KS

• KMID: 2277712
• DOI: http://doi.org/10.5223/kjpgn.2011.14.4.398

Abstract

Gastric outlet obstruction (GOO) results from obstructing lesions in the region of the pyloric channel. In neonates, hypertrophic pyloric stenosis (HPS) is the most common cause while peptic ulcer is a rare cause. Neonatal gastric ulcer is relatively frequent in preterm newborn babies or in neonates treated in intensive care units. In healthy neonates, mucosal ulcers are associated with stressful conditions. In gastric ulcer diseases, gastric outlet obstruction is usually caused by a combination of edema, spasm, fibrotic stenosis and gastric atony. We experienced a case of neonatal gastric ulcer with a large hematoma in a 3-day-old infant presenting with repeated vomiting, poor oral intake, and abdominal distension. For the differential diagnosis, we did abdominal ultrasonography. Hematoma was diagnosed by abdominal ultrasonography. Endoscopic examination confirmed the hematoma and the presence of gastric ulcerations. We report this case with a brief review of the literature.

Keyword

Gastric outlet obstruction; Neonate; Gastric ulcer; Hematoma

MeSH Terms

Constriction, Pathologic
Diagnosis, Differential
Edema
Gastric Outlet Obstruction
Hematoma
Humans
Infant
Infant, Newborn
Intensive Care Units
Peptic Ulcer
Pyloric Stenosis, Hypertrophic
Spasm
Stomach Diseases
Stomach Ulcer
Ulcer
Vomiting

Figure

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  Fig. 1 (A) Ultrasonography shows a 3.3 cm sized round soft tissue echoic lesion suggestive of hematoma in the lumen of the stomach. (B) On color ultrasonography, no color flows are seen in the soft tissue lesion.

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  Fig. 2 (A) Multiple ulcers with an erythematous rim are seen in the stomach body. (B) A large hematoma is seen in the stomach fundus, before suction. (C) A hematoma is seen in the stomach fundus, after suction.

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