Gastric Antral Web in a 103-Year-Old Patient

Gastric antral web, also called antral diaphragm, is a rare cause of gastric-outlet obstruction. First described by Touroff et al. in 1940 [1], gastric antral web (GAW) or gastric antral diaphragm is a relatively rare and controversial entity. Both congenital and acquired etiologies have been postulated for this lesion in adults. The congenital theory recognizes that GAW occurs in infants and children. During the second month of embryologic development, the lumen of the developing digestive tract is plugged by a rapid overgrowth of epithelial cells. Vacuoles subsequently appear in the plugs and eventually coalesce to reestablish gut patency. The proposed mechanism for GAW is the failure of vacuoles to coalesce in the stomach [2]. However, acquired antral web in adults due to peptic diseases has also been documented [1, 3]. Approximately-one-quarter of all reported cases of GAW has been associated with either gastric or duodenal ulcer disease. Acquired etiology may be caused by scarring of the linear circumferential prepyloric and pyloric ulcers [4].