2026 Volume 62 Issue 4 Pages 866-871
A 15-year-old girl presented with postprandial vomiting, abdominal pain, and weight loss over several months. She visited a local doctor and was subsequently referred to our department owing to pneumatosis intestinalis in the jejunum and ileum, along with marked dilatation of the stomach and duodenum, as shown on a CT scan. Her vital signs were stable, and no abdominal tenderness was noted. The patient was managed with fasting and intravenous fluid support while undergoing stepwise evaluation. Within a few days of admission, the intestinal emphysema showed signs of improvement. Upper gastrointestinal endoscopy revealed a duodenal web proximal to Vater’s papilla, leading to the diagnosis of congenital duodenal stenosis and intestinal emphysema due to increased internal pressure in the stomach and duodenum. Endoscopic balloon dilatation was attempted but proved insufficient. Consequently, laparoscopic duodenoduodenostomy was performed, resulting in a favorable outcome. This case highlights a rare presentation of pneumatosis intestinalis with congenital duodenal stenosis. We report this case owing to the challenges encountered in understanding the pathophysiology of pneumatosis intestinalis with congenital duodenal stenosis and determining the optimal treatment approach.
