Congenital Microgastria: Treatment with a Hunt- Lawrence Pouch

Congenital microgastria results in growth retardation early in a patient’s life due to poor oral intake, malnutrition and failure to gain weight. An one-month-old female was admitted with a history of poor oral intake, vomiting and recurrent pneumonia after birth. She had an extremely small, tubular stomach in the midline of the abdomen, a megaesophagus and severe gastroesophageal reflux (Reflux Index: 41.1%, DeMeester score: 152.2). A Hunt- Lawrence Pouch (Roux-en-Y double barrel jejunal food pouch formation) procedure was performed for augmenting the small stomach after failure of conservative management such as small, frequent feedings and prokinetics. The postoperative UGI and esophageal pH study showed marked improvement of the GER (13.7%, 68.9 respectively). Although her preoperative symptoms have subsided, her weight is still below normal (third percentile). Creating a Hunt-Lawrence pouch is the treatment of choice for congenital microgastria that is refractory to conservative management.ope