Case Report
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World J Gastroenterol. Oct 7, 2013; 19(37): 6292-6295
Published online Oct 7, 2013. doi: 10.3748/wjg.v19.i37.6292
Video capsule endoscopy and CT enterography in diagnosing adult hypertrophic pyloric stenosis
Grigoriy E Gurvits, Amy Tan, Dmitri Volkov
Grigoriy E Gurvits, Department of Gastroenterology, New York University School of Medicine/Langone Medical Center, New York, NY 10016, United States
Amy Tan, Department of Medicine, New York University School of Medicine, New York, NY 10016, United States
Dmitri Volkov, Department of Anesthesiology, New York University School of Medicine/Langone Medical Center, New York, NY 10016, United States
Author contributions: Gurvits GE, Tan A and Volkov D contributed equally to this work.
Correspondence to: Grigoriy E Gurvits, MD, Department of Gastroenterology, New York University School of Medicine/Langone Medical Center, 530 First Avenue, SKI-9N, New York, NY 10016, United States. dr.gurvits@hotmail.com
Telephone: +1-212-2633095 Fax: +1-212-2633096
Received: April 25, 2013
Revised: August 1, 2013
Accepted: August 4, 2013
Published online: October 7, 2013
Processing time: 175 Days and 21.9 Hours
Abstract

Primary adult hypertrophic pyloric stenosis is a rare but important cause of gastric outlet obstruction that may be misdiagnosed as idiopathic gastroparesis. Clinically, patients present with early satiety, abdominal fullness, nausea, epigastric discomfort and eructation. Permanent gastric retention of a video capsule endoscope is diagnostic in differentiating between the two diseases, in the absence of an organic gastric outlet obstruction. This case presents the longest video capsule retention in the medical literature to date. It is also the first case report of adult hypertrophic pyloric stenosis diagnosed with video capsule endoscopy or a computed tomography scan. Finally, an unusual “plugging” of the gastric outlet with free floating capsule has an augmented effect on disease physiology and on patient’s symptoms.

Keywords: Video capsule endoscopy; Hypertrophic pyloric stenosis; Gastroparesis; Endoscopy; Computed tomography enterography

Core tip: Classic descriptors and latest developments and potential role for capsule endoscopy in differential diagnosis of adult hypertrophic pyloric stenosis (HSP). First ever case of 3 years of video capsule retention in a patient. First ever report of diagnosing adult HPS with video capsule and/or with computed tomography-enterography. Physiologic effects of video capsule on symptoms in adult HPS. Differentiating between adult HPS and gastroparesis. Advances in treatment of adult HPS.