Gastric pneumatosis (gas in the wall of the stomach) is an uncommon but characteristic plain-film radiographic sign. In infancy it is associated either with gastric outlet obstruction, usually hypertrophic pyloric stenosis, or necrotizing gastroenterocolitis. Differential diagnosis is mainly based on associated clinical findings, as exemplified by the 2 cases reported here. Both infants had isolated gastric pneumatosis as the principal radiographic finding. Correct diagnosis was greatly aided by recognition of this x-ray sign so that appropriate therapy was started without delay.
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