Published online Oct 7, 2013. doi: 10.3748/wjg.v19.i37.6292
Revised: August 1, 2013
Accepted: August 4, 2013
Published online: October 7, 2013
Processing time: 175 Days and 21.9 Hours
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.
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.