Asia Oceania Journal of Nuclear Medicine and Biology

Asia Oceania Journal of Nuclear Medicine and Biology

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

Document Type : Case report

Authors
Khadijah R Sumitro 1, 2
Andy Darma 1, 2
Tri P Sucianti 3
Stepanus Massora 3
Alpha F Athiyyah 1, 2
Reza G Ranuh 1, 2
Subijanto M Soedarmo 1, 2
1 Department of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
2 Department of Child Health, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
3 Division of Nuclear Medicine, Department of Radiology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
10.22038/aojnmb.2025.84182.1599
Abstract
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.
Keywords
Pediatric
Gastroparesis
Gastric emptying scintigraphy
Intra-pyloric botulinum toxin
Subjects
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Asia Oceania Journal of Nuclear Medicine and Biology
Volume 13, Issue 2
July 2025
Pages 190-194