Gastrectomy with isoperistaltic jejunal parallel pouch in a 15-year-old adolescent boy with gastric adenocarcinoma and autosomal recessive agammaglobulinemia

Abstract A 15-year-old adolescent boy with autosomal recessive agammaglobulinemia underwent endoscopy because of unexplained growth failure and malnutrition. Esophagogastroduodenoscopy revealed antropyloric stenosis, and a biopsy showed an invasive gastric adenocarcinoma. Chronic atrophic corpus gas...

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Bibliographic Details
Published in:Journal of pediatric surgery 2011-09, Vol.46 (9), p.e21-e24
Main Authors: Slotta, Jan E, Heine, Sabine, Kauffels, Anne, Krenn, Thomas, Grünhage, Frank, Wagner, Mathias, Graf, Norbert, Schilling, Martin K, Schuld, Jochen
Format: Article
Language:English
Subjects:
Adenocarcinoma - complications
Adenocarcinoma - surgery
Adolescent
Agammaglobulinemia - complications
Autosomal recessive agammaglobulinemia
Chronic atrophic gastritis
Gastrectomy
Gastric cancer
Humans
Jejunal pouch
Jejunum - surgery
Male
Pediatrics
Peristalsis
Stomach - surgery
Stomach Neoplasms - complications
Stomach Neoplasms - surgery
Surgery
Surgically-Created Structures
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Summary:Abstract A 15-year-old adolescent boy with autosomal recessive agammaglobulinemia underwent endoscopy because of unexplained growth failure and malnutrition. Esophagogastroduodenoscopy revealed antropyloric stenosis, and a biopsy showed an invasive gastric adenocarcinoma. Chronic atrophic corpus gastritis type A and Helicobacter pylori were also identified. Abdominal magnetic resonance imaging confirmed the stenosis resulting from a semicircular intramural tumor without obvious local or distant metastatic spread. Gastrectomy with an extended lymphadenectomy was performed. Esophagoduodenal continuity was restored by an interposed jejunal parallel pouch developed from the first jejunal loop. Oral feeding was supplemented by parenteral nutrition via a Broviac catheter, and the patient is well 4 months later. Several cases of gastric cancer have been reported in children with hereditary agammaglobulinemia. Thus, endoscopy is mandatory in such patients with gastrointestinal symptoms to identify and treat tumors before metastasis occurs. Total gastrectomy, extended lymphadenectomy, and reconstruction using a jejunal reservoir with maintenance of duodenal continuity should be considered.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2011.06.005