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Case Rep Gastrointest Med. 2014;2014:527471. doi: 10.1155/2014/527471. Epub 2014 Jan 14.

Gastric adenocarcinoma presenting with gastric outlet obstruction in a child.

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Division of Pediatric Gastroenterology, Hepatology & Nutrition, Children's Hospital, University of King Saud for Health Sciences, King Fahad Medical City, P.O. Box 59046, Riyadh 11525, Saudi Arabia.
Department of Pediatrics, College of Medicine, King Saud University and King Khalid University Hospital, Riyadh, Saudi Arabia.
Oncology/Hematology Division, King Saud Medical City, P.O. Box 58594, Riyadh 11515, Saudi Arabia.
King Faisal Specialist Hospital and Research Center, Department of Surgery, P.O. Box 3354, Riyadh 11211, Saudi Arabia.


Gastric carcinoma is extremely rare in children representing only 0.05% of all gastrointestinal malignancies. Here, we report the first pediatric case of gastric cancer presenting with gastric outlet obstruction. Upper endoscopy revealed a markedly thickened antral mucosa occluding the pylorus and a clean base ulcer 1.5 cm × 2 cm at the lesser curvature of the stomach. The narrowed antrum and pylorus underwent balloon dilation, and biopsy from the antrum showed evidence of Helicobacter pylori gastritis. The biopsy taken from the edge of the gastric ulcer demonstrated signet-ring-cell type infiltrate consistent with gastric adenocarcinoma. At laparotomy, there were metastases to the liver, head of pancreas, and mesenteric lymph nodes. Therefore, the gastric carcinoma was deemed unresectable. The patient died few months after initiation of chemotherapy due to advanced malignancy. In conclusion, this case report underscores the possibility of gastric adenocarcinoma occurring in children and presenting with gastric outlet obstruction.

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