ANTRAL DYSMOTILITY - AN UNRECOGNIZED CAUSE OF CHRONIC VOMITING DURING INFANCY

  • 1 January 1981
    • journal article
    • research article
    • Vol. 193  (4) , 521-524
Abstract
Ten infants who were < 9 mo. of age and had chronic nonbilious vomiting were evaluated for gastroesophageal reflex. Upper gastrointestinal series in all showed delayed gastric emptying, a funnel-shaped antrum, absent antral peristalsis and gastroesophageal reflux. None had evidence of anatomic obstruction in the stomach or duodenum. Manometric studies of the esophagus revealed normal (4 patients) or elevated (6 patients) lower esophageal sphincter pressures. One h esophageal pH probe tests were negative in 7 of the 10 infants. This obstruction to gastric emptying appears to represent a disorder of antral motility. Medical management, which consisted of small frequent feedings and postural therapy, was successful in 6 of the infants. The remaining 4 patients required pyloroplasty. All of the infants are now asymptomatic and gaining weight at a normal or accelerated rate for their ages. Familiarity with this previously undescribed disorder should prevent the incorrect diagnosis of gastroesophageal reflux secondary to lower esophageal sphincter incompetence and the resulting inappropriate surgical reconstruction.