Duplication of the stomach.

A female infant aged 4 weeks was admitted to the City Hospital, Aberdeen, on March 31, 1955. Ten days previously she had an episode of vomiting, and on the day of admission she passed a green, slimy stool. At birth she weighed 9 lb. 4 oz. and delivery was spontaneous at full term. She was fed on breast milk for two weeks after birth but the supply became insufficient. Before admission she was receiving 5 oz. of a mixture of cow's milk and water four-hourly five times daily. Her brother, aged 5, and her mother were well, but the father was in hospital with acute nephritis. On examination the baby was small but not dehydrated. Her weight (8 lb. 10 oz.) indicated retarded growth. A smooth swelling, 1 .s2 in. in area, was visible in the left hypochondrium; it was firm and apparently fixed but it could be partially surrounded by one's fingers. When the baby was fed, however, the swelling became firmer and moved downwards and inwards. No peristalsis was seen. A mouthful of feed was possetted but no true vomiting occurred. Four days after admission a barium meal was given but there were no diagnostic radiological findings. The abdominal mass remained unchanged. However, the baby fed well and gained weight until April 12 when she developed symptoms of gastro-enteritis due to crossinfection with E. coli Oll B4. On one occasion during this illness frank blood was observed in the stool. Despite antibiotic (tetracycline) therapy cultures of stool remained positive. The baby gradually regained her health, however, her appetite returned and she gained in weight, but the abdominal swelling remained unchanged. On July 1 radiological examination was repeated. No abnormality was detected after a barium meal until the baby sucked from an empty bottle and thus distended the stomach with air. The tumour was then seen protruding into the stomach and appeared to be attached to the middle part of the greater curvature (Fig. 1). Laparotomy was advised and the baby was therefore transferred to the Royal Hospital for Aberdeen, for surgical treatment. Sick Children,