Resumen

JIMENEZ-MENDEZ, María Gabriela  y  CARMONA-BARBA, René. Jodhpur Disease resolved by laparoscopic pyloroplasty. Acta méd. costarric [online]. 2015, vol.57, n.1, pp.38-41. ISSN 0001-6002.

Background: Primary and acquired gastric outlet obstruction was described in 1997 when the first reports were released. It is an unusualillness, widely unknown among pediatric surgeons; therefore the aim of this paper is to present a case and provide a brief analysis of the disease. Case report: We report the case of a three-year old girl, with a three-month history of worsening postprandial non-bilious vomiting, abdominal pain and weight loss. The upper gastrointestinal contrast study showed an enlarged stomach and delayed gastric emptying, with contrast up to 72 hours later. Endoscopy displayed a stenotic pylorus. The result of the histopathologic examination was normal. Nonetheless, she didn’t respond to medical treatment. A diagnostic laparoscopy wasperformed,butextrinsiccompressioncausesweredismissed and it showed a normal pylorus, so a laparoscopic Heineke-Mikulicz antropyloroplasty was performed. It dismissed the presence of a membrane but showed a fibrotic pyloric ring that was resected. She presented a satisfactory postoperative course. Discussion: This case is grouped in the category of primary and acquired obstructions to gastric emptying or Jodhpur’s Disease, which is characterized by clinical symptoms like non-bilious vomiting, visible gastric peristalsis and weight loss with no apparent cause (no membrane or diaphragm); a histopathological study that dismissed other pathologies (no fibrosis, no specific inflammation, no malignancy) and by the fact that it may be easily resolved using a Mikuliczpyloroplasty. This case shows that although this is a rare entity, it should be considered after ruling out other more common diseases. It is also possible to conclude that the laparoscopic approach for antropyloroplasty is safe and effective.

Palabras clave : Gastric outlet; pylorus; laparoscopy.

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