Gastric Outlet Obstruction Caused by Heterotopic Pancreas in an Adolescent

Excerpt

A 16-year-old previously healthy girl was referred to a community-based pediatric gastroenterologist with a 6-month history of epigastric pain, nausea, and nonbilious emesis. The pain and vomiting worsened with eating, occurred mostly at nighttime, but did not wake her from sleep. During this time, she also complained of abdominal distention, bloating, and heartburn. Two months prior to the onset of these symptoms, she experienced a presumed viral illness with fever, sore throat, and fatigue lasting 3 days. Testing for streptococcal pharyngitis and infectious mononucleosis was negative at that time. Her past medical history was only significant for migraine headaches. She was an honor student and cheerleader at a competitive high school. Her physical examination was normal as were a comprehensive metabolic panel, measurement of serum inflammatory markers, and serum amylase and lipase levels. …