Isolated Congenital Microgastria in Infancy: Diagnostic Evaluation and Surgical Reconstruction with Hunt–Lawrence Pouch

A BSTRACT Congenital microgastria is an exceptionally rare foregut developmental anomaly characterised by a markedly small, poorly functioning stomach, resulting in severe feeding intolerance and failure to thrive. Isolated congenital microgastria, occurring in the absence of associated anomalies, is particularly uncommon. We report a 12-month-old male infant who presented with persistent postprandial vomiting since early infancy, severe malnutrition, and recurrent aspiration-related respiratory infections. Radiological evaluation revealed a markedly dilated oesophagus and a diminutive, tubular stomach. The child underwent gastric augmentation using a Hunt–Lawrence jejunal pouch, which successfully restored gastric reservoir capacity. At 12-month follow-up, he demonstrated excellent nutritional recovery and sustained clinical improvement, with no evidence of contrast hold-up in the oesophagus or reconstructed stomach. This case underscores the importance of maintaining a high index of suspicion for congenital microgastria in infants with unexplained feeding intolerance and highlights the Hunt–Lawrence pouch as a safe and effective surgical option for long-term functional restoration in this exceedingly rare condition.