An Infant Case of Gastric Duplication Presenting With Severe Anemia Due to Intra-abdominal Hemorrhage

Abstract

A previously healthy female infant presented with poor activity and severe anemia at one month of age. Imaging suggested an intra-abdominal hemorrhage due to a bleeding lymphangioma. The patient was thus admitted for observation. As no further bleeding occurred, the patient was discharged on hospital day seven. Bleeding recurred on day 14, and diagnostic laparoscopy was performed on day 28. A hematoma in the transverse mesocolon was identified and resected. A new hematoma formed on day 51, and intra-abdominal hemorrhage occurred on day 74. Further investigation by ultrasonography revealed a cystic lesion along the greater curvature of the stomach, which was suspected to be a gastric duplication. Laparotomy was performed on day 84. Intraoperative findings revealed a perforated gastric duplication within the greater omentum near the gastric antrum. The source of recurrent intra-abdominal hemorrhage and mesenteric hematoma was bleeding from the lesion. The gastric duplication was resected, and the defect was repaired. The patient’s postoperative course was uneventful, and she was discharged on day 94. To the best of our knowledge, no previous report has described a gastric duplication in an infant presenting with recurrent intra-abdominal hemorrhage or anemia. The rarity of such a presentation resulted in significant diagnostic difficulty. We report this case with a review of the relevant literature.