Abstract
Long-term prostaglandin (PG) therapy has recently been associated with gastric mucosal hyperplasia. We reviewed the clinical and radiologic (especially sonographic) records of eight patients with complex congenital heart disease who were on PG therapy. Feeding problems, vomiting, and abdominal distension were present in six patients. Barium meal revealed antral narrowing in three patients, suggestive of hypertrophic pyloric stenosis in two. Sonography showed a variable degree of increased gastric mucosal lobulation often accompanied by a marked polypoid or lobular appearance. Cortical hyperostosis related to PG therapy was seen in three patients. PG-associated gastric mucosal hyperplasia can cause feeding problems and pronounced gastric lobulation.
Similar content being viewed by others
References
Thanopoulos BD, Andreou AA, Frimas C (1987) Prostaglandin F2 administration in infants with ductus-dependent cyanotic congenital heart disease. Eur J Pediatr 146: 279–282
Lewis AB, Freed MD, Heymann MA, Roehl SL, Kensey RC (1981) Side effects of therapy with prostaglandin E1 in infants with critical congenital heart disease. Circulation 64: 893–898
Host A, Halken S, Andersen PE Jr (1988) Reversibility of cortical hyperostosis following long-term prostaglandin E1 therapy in infants with ductus-dependent congenital heart disease. Pediatr Radiol 18: 149–153
Ueda K, Saito A, Nakano H, Aoshima M Yokota M, Muraoka R, Iwaya T (1980) Cortical hyperostosis following long-term administration of prostaglandin E1 in infants with cyanotic congenital heart disease. J Pediatr 97: 834–836
Peled N, Dagan O, Babyn P, Silver MM, Barker G, Hellmann J, Scolnik D, Koren G (1992) Gastric outlet obstruction induced by prostaglandin therapy in neonates. N Engl J Med 327: 505–510
Tytgat GNJ, Offerhaus GJA, Van Minnen AJ, Everts V, Hensen-Logmans SC, Samson G (1986) Influence of oral 15 (R)-15-methyl prostaglandin E2 on human gastric mucosa: a light microscopy, cell kinetic, and ultrastructural study. Gastroenterology 90: 1111–1120
Classen M, Sturzenhofecker P, Koch H, Demling L (1973) The effect of prostaglandin E1 on the secretion and the motility of the human stomach. Acta hepatol Gastroenterol 20: 159–162
Milla PJ (1992) Gastric outlet obstruction in children. N Engl J Med 327: 558–559
Goodlad RA, Madgwick AJ, Moffaft MR, Levin S, Allen JL (1989) Prostaglandins and the gastric epithelium: effects of misoprostol on gastric epithelium cell proliferation in the dog. Gut 30: 316–321
Hawkey CJ, Rampton DS (1985) Prostaglandins and the gastrointestinal mucosa: are they important in its function, disease or treatment? Gastroenterology 89: 1162–1188
Reinhart WH, Muller O, Halter F (1983) Influence of long-term 16, 16-Dimethyl prostaglandin E2 treatment on the rat gastrointestinal mucosa. Gastroenterology 85: 1003–1010
Boyd EJS, Hulks G, Thomas JStJ, McColl KEL (1988) Hypertrophic gastritis associated with increased gastric mucosal prostaglandin E2 concentrations in a patient with the carcinoid syndrome. Gut 29: 1270–1276
Mercado-Deane MG, Burton EM, Brawley AV, Hatley R (1994) Prostaglandin-induced foveolar hyperplasia simulating pyloric stenosis in an infant with cyanotic heart disease. Pediatr Radiol 24: 45–46
Stringer DA, Daneman A, Brunelle F, Ward K, Martin D (1986) Sonography of the normal and abnormal stomach (excluding hypertrophic pyloric stenosis) in children. j Ultrasound Med 5: 183–188
Blumhagen JD (1986) The role of ultrasonography in the evaluation of vomiting in infants. Pediatr Radiol 16: 267–270
Swischuk LE, Hayden CK, Stansberry SD (1989) Sonographic pitfalls in imaging of the antropyloric region in infants. Radiographics 9: 437–447
Rollins MD, Shields MD, Quinn RJM, Wouldridge MAN (1991) Value of ultrasound in differentiating causes of peristent vomiting in infants. Gut 32: 612–614
O'Keeffe FN, Stansberry SD, Swischuk LE, Hayden CK (1991) Antropyloric muscle thickness at US in infants: what is normal? Radiology 178: 827–830
Bar-Ziv J, Barki Y, Weizman Z, Urkin J (1988) Transient protein-losing gastropathy (Ménétrier's disease) in childhood. Pediatr Radiol 18: 82–84
McAlister WH, Katz ME, Perlman JM, Tack ED (1988) Sonography of focal foveolar hyperplasia causing gastric obstruction in an infant. Pediatr Radiol 18: 79–81
Hayden CK Jr, Swischuk LE, Rytting JE (1987) Gastric ulcer disease in infants. Radiology 164: 131–134
Katz ME, Blocker SH, McAlister WH (1985) Focal foveolar hyperplasia presenting as an antral-pyloric mass in a young infant. Pediatr Radiol 15: 136–137
Chouraqui JP, Roy CC, Brochur P, Gregoire H, Morin CL, Weber AM (1981) Ménétrier's disease in childhood: report of a patient and review of sixteen other cases. Gastroenterology 80: 1042–1047
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Babyn, P., Peled, N., Manson, D. et al. Radiologic features of gastric outlet obstruction in infants after long-term prostaglandin administration. Pediatr Radiol 25, 41–43 (1995). https://doi.org/10.1007/BF02020842
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02020842