Prepyloric Diaphragm in Children: A Diagnosis Not to be Missed.

Background: Prepyloric diaphragm is a rare cause of gastric outlet obstruction (GOO). Accurate diagnosis is often difficult and is usually confirmed after surgery. To avoid delayed management, this entity, with its specific clinical and radiological features, should be kept in mind.

Case presentation: We report a case of prepyloric diaphragm in a 7-month year old boy. He presented with non-bilious vomiting since birth. A first upper gastrointestinal series was initially misinterpreted as gastroesophageal reflux. After re-examination of the gastrointestinal series, a pyloric obstacle was suspected, and a second Contrast study evoked a pyloric obstacle which gave rise to the indication for surgical exploration after resuscitation. Endoscopy was suggestive of the diagnosis and the accurate diagnosis was done during surgery.

Conclusion: This report illustrates the complexity of this diagnosis. Knowledge of this entity and a good, detailed analysis of contrast study in combination with ultrasound and endoscopy could lead to a rapid diagnosis and an adequate care with a good prognosis.