A gastric outlet thickened mucosal fold associated with cytomegalovirus infection in an extremely preterm infant managed by surgical resection

Paediatr Int Child Health. 2021 Sep 14:1-4. doi: 10.1080/20469047.2021.1967626. Online ahead of print.ABSTRACTNon-bilious vomiting in preterm neonates discharged from neonatal intensive care units is a common complaint and is often associated with benign conditions such as gastro-oesophageal reflux. A neonate of 27 weeks gestation who presented later with vomiting owing to gastric outlet obstruction is described. He was discharged at 11 weeks of age and required re-admission 1 week later. He had persistent non-bilious vomiting from 7 weeks of age, failure to thrive and metabolic alkalosis. Clinical examination demonstrated visible gastric peristalsis, and hypertrophic pyloric stenosis was suspected. Ultrasound of the gastric pylorus and upper gastro-intestinal contrast studies were negative. Exploratory laparotomy after failure of conservative management revealed a thickened mucosal fold in the gastric pylorus, which was excised. Histopathology demonstrated inclusion bodies which are pathognomonic of cytomegalovirus infection. He was treated with valganciclovir for 6 weeks and was asymptomatic and thriving well at follow-up. Gastric outlet obstruction can be one of the manifestations of CMV infection of the gastro-intestinal tract. Diagnosis can be confirmed only by histopathology.Abbreviations: BPD: bronchopulmonary dysplasia; CMV: cytomegalovirus; H&E: haematoxylin and eosin; IHC: immunohistochemistry; IHPS: infantile hypertrophic pyloric stenosis; NEC: necrotising enteroco...
Source: Paediatrics and international child health - Category: Pediatrics Authors: Source Type: research

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More News: Acid Reflux | Bronchopulmonary Dysplasia | Children | Correction of Pyloric and Duodenal Stenosis | Cytomegalovirus | Gastroenterology | Gastroesophageal Reflux Disease | GERD | Intensive Care | Laparotomy | Pediatrics | Perinatology & Neonatology | Pyloric Stenosis | Study | Ultrasound