Intra-pyloric botulinum toxin injection improves liquid gastric emptying using 99mTc DTPA scintigraphy: a case report in a 2 years- old girl with idiopathic gastroparesis

Gastroparesis, characterized by delayed gastric emptying in the absence of mechanical obstruction, is a challenging condition to diagnose and treat in children due to limited pediatric-specific data. This case report presents a 15-month-old girl with recurrent and chronic vomiting since infancy, whi...

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Main Authors: Khadijah Sumitro, Andy Darma, Tri Sucianti, Stepanus Massora, Alpha Athiyyah, Reza Ranuh, Subijanto Soedarmo
Format: Article
Language:English
Published: Mashhad University of Medical Sciences 2025-07-01
Series:Asia Oceania Journal of Nuclear Medicine and Biology
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Online Access:https://aojnmb.mums.ac.ir/article_25824_1870d52c1326fd8a650dfa3314adceb1.pdf
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author Khadijah Sumitro
Andy Darma
Tri Sucianti
Stepanus Massora
Alpha Athiyyah
Reza Ranuh
Subijanto Soedarmo
author_facet Khadijah Sumitro
Andy Darma
Tri Sucianti
Stepanus Massora
Alpha Athiyyah
Reza Ranuh
Subijanto Soedarmo
author_sort Khadijah Sumitro
collection DOAJ
description Gastroparesis, characterized by delayed gastric emptying in the absence of mechanical obstruction, is a challenging condition to diagnose and treat in children due to limited pediatric-specific data. This case report presents a 15-month-old girl with recurrent and chronic vomiting since infancy, which worsened upon the introduction of solid foods. Initial diagnostic evaluations, including esophagogastroduodenoscopy (EGD) and upper gastrointestinal contrast study, ruled out structural abnormalities. A gastric emptying scintigraphy (GES) with 99mTc DTPA confirmed significant gastric retention, leading to a diagnosis of idiopathic gastroparesis. Endoscopic intra-pyloric botulinum toxin injection (IPBI) was performed and resulting in significant symptom improvement. Post-procedure assessments revealed improved gastric emptying, with reduced retention at 60 and 180 minutes and a markedly decreased half-time (t1/2) was shown following the procedure. These findings highlight that IPBI may be a promising therapeutic option for pediatric idiopathic gastroparesis unresponsive to standard treatments. Further research is warranted to refine treatment protocols and evaluate long-term outcomes.
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issn 2322-5718
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language English
publishDate 2025-07-01
publisher Mashhad University of Medical Sciences
record_format Article
series Asia Oceania Journal of Nuclear Medicine and Biology
spelling doaj-art-8542d6acf1cc413e8b769b51ac9b941f2025-06-25T05:17:52ZengMashhad University of Medical SciencesAsia Oceania Journal of Nuclear Medicine and Biology2322-57182322-57262025-07-0113219019410.22038/aojnmb.2025.84182.159925824Intra-pyloric botulinum toxin injection improves liquid gastric emptying using 99mTc DTPA scintigraphy: a case report in a 2 years- old girl with idiopathic gastroparesisKhadijah Sumitro0Andy Darma1Tri Sucianti2Stepanus Massora3Alpha Athiyyah4Reza Ranuh5Subijanto Soedarmo6Department of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, IndonesiaDepartment of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, IndonesiaDivision of Nuclear Medicine, Department of Radiology, Dr. Soetomo General Academic Hospital, Surabaya, IndonesiaDivision of Nuclear Medicine, Department of Radiology, Dr. Soetomo General Academic Hospital, Surabaya, IndonesiaDepartment of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, IndonesiaDepartment of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, IndonesiaDepartment of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, IndonesiaGastroparesis, characterized by delayed gastric emptying in the absence of mechanical obstruction, is a challenging condition to diagnose and treat in children due to limited pediatric-specific data. This case report presents a 15-month-old girl with recurrent and chronic vomiting since infancy, which worsened upon the introduction of solid foods. Initial diagnostic evaluations, including esophagogastroduodenoscopy (EGD) and upper gastrointestinal contrast study, ruled out structural abnormalities. A gastric emptying scintigraphy (GES) with 99mTc DTPA confirmed significant gastric retention, leading to a diagnosis of idiopathic gastroparesis. Endoscopic intra-pyloric botulinum toxin injection (IPBI) was performed and resulting in significant symptom improvement. Post-procedure assessments revealed improved gastric emptying, with reduced retention at 60 and 180 minutes and a markedly decreased half-time (t1/2) was shown following the procedure. These findings highlight that IPBI may be a promising therapeutic option for pediatric idiopathic gastroparesis unresponsive to standard treatments. Further research is warranted to refine treatment protocols and evaluate long-term outcomes.https://aojnmb.mums.ac.ir/article_25824_1870d52c1326fd8a650dfa3314adceb1.pdfpediatricgastroparesisgastric emptying scintigraphyintra-pyloric botulinum toxin
spellingShingle Khadijah Sumitro
Andy Darma
Tri Sucianti
Stepanus Massora
Alpha Athiyyah
Reza Ranuh
Subijanto Soedarmo
Intra-pyloric botulinum toxin injection improves liquid gastric emptying using 99mTc DTPA scintigraphy: a case report in a 2 years- old girl with idiopathic gastroparesis
Asia Oceania Journal of Nuclear Medicine and Biology
pediatric
gastroparesis
gastric emptying scintigraphy
intra-pyloric botulinum toxin
title Intra-pyloric botulinum toxin injection improves liquid gastric emptying using 99mTc DTPA scintigraphy: a case report in a 2 years- old girl with idiopathic gastroparesis
title_full Intra-pyloric botulinum toxin injection improves liquid gastric emptying using 99mTc DTPA scintigraphy: a case report in a 2 years- old girl with idiopathic gastroparesis
title_fullStr Intra-pyloric botulinum toxin injection improves liquid gastric emptying using 99mTc DTPA scintigraphy: a case report in a 2 years- old girl with idiopathic gastroparesis
title_full_unstemmed Intra-pyloric botulinum toxin injection improves liquid gastric emptying using 99mTc DTPA scintigraphy: a case report in a 2 years- old girl with idiopathic gastroparesis
title_short Intra-pyloric botulinum toxin injection improves liquid gastric emptying using 99mTc DTPA scintigraphy: a case report in a 2 years- old girl with idiopathic gastroparesis
title_sort intra pyloric botulinum toxin injection improves liquid gastric emptying using 99mtc dtpa scintigraphy a case report in a 2 years old girl with idiopathic gastroparesis
topic pediatric
gastroparesis
gastric emptying scintigraphy
intra-pyloric botulinum toxin
url https://aojnmb.mums.ac.ir/article_25824_1870d52c1326fd8a650dfa3314adceb1.pdf
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