Endoscopic resection of an obstructing antral web in an infant

An antral web was discovered during the work-up of postcibal vomiting in an 18-month-old infant. An omphalocele repair had been performed previously and altered intraperitoneal anatomic relationships favored an endoscopic approach to web resection. The method devised was successful in removing the web; however, six weeks later laparotomy was necessary because of recurrent vomiting. At surgery the web was completely gone, although a circumferential ulcer was now present at the site of the prior web. Antroplasty was curative. An endosopic approach to antral webs is feasible and may in certain cases obviate laparotomy.