Article
Food entrapped in papilla of Vater: uncommon cause of vomiting
D Falchetti, P Pedersini, W Rigamonti, P Salucci, G Caccia
Chirurgia
Pediatrica, Spedali Civili, P.le Spedali Civili, 25100 Brescia, Italy
Correspondence to: Dr Falchetti email: falchet{at}bshosp.osp.unibs.it
Accepted 30 November
1999
CASE REPORT
A 20 month old girl was
admitted for intractable vomiting over several days, with no other
symptoms. Family and personal history were not contributive. Clinical
and neurological examination, and routine blood tests and
investigations (plain abdominal x ray, upper
gastrointestinal tract contrast study, abdominal ultrasonography) were
normal. The upper gastrointestinal endoscopy showed a mild antral
gastritis and the second portion of duodenum was occupied by a tough,
fibrous mass partially embedded into the papilla of Vater. The foreign
body was removed and proved to be vegetable fibre (pineapple). Symptoms
subsided immediately and the child was discharged with gastroprotective
therapy. After two months, on endoscopic examination, the signs of
gastropathy had cleared; the papilla of Vater was undamaged, but
unchomped food debris was again found in the duodenum.
DISCUSSIONThere are sporadic
reports of foreign bodies retained into the papilla of Vater, all of
them in adults. This child, though her papilla was tiny, had no
jaundice or pancreatitis, unlike most of the reported cases. This is
the first report of this finding in a child. The cause of the vomiting
was not shown on abdominal ultrasonography or contrast study. It should
be added to the list of unusual causes of vomiting.
Keywords: vomiting; children; papilla of Vater; endoscopy
© 2000 by Archives of Disease in Childhood
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Arch. Dis. Child. 2000 82: 0.[Extract] [Full Text]
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