Gastromegaly and Chronic Duodenal Ileus in Children.

This paper is concerned with a series of nine children who exhibited enlargement of the stomach with visible gastric peristalsis or other signs of obstruction high in the alimentary tract. The similarity between the cases is sufficient to suggest that they all belong to one group originating in some form of duodenal obstruction. Two of the nine cases were submitted to operation and were found to be examples of chronic duodenal ileus, and it is suggested that the others of the series owe their origin to the same cause. Gastromegaly is a convenient term for the enlarged and hypertrophied stomach which is the most striking clinical feature of such cases as these. Such a condition implies obstruction to the evacuation of the stomach and may be due to various causes; and as the site and nature of the obstruction, and even its very presence, may be difficult to determine, it is useful to have a group name which covers all such cases and emphasizes their one most obvious clinical abnormality. Were, for instance, the diagnosis of chronic duodenal ileus in the present cases disputed (and the subject is one of great difficulty), they would remain as a type of gastromegaly of obscure origin. Duodenal ileus and arterio-mesenteric occlusion of the duodenum are the terms given to the condition in which the duodenum is compressed by the root of the mesentery and (usually) the superior mesenteric artery, as they lie over the duodeno-jejunal flexure. Both acute and chronic duodenal ileus are well recognized conditions in adults. This paper is concerned only with the chronic type, and as it occurs in children.