Recurrent Infantile Hypertrophic Pyloric Stenosis in the Emergency Department: A Case Report

Authors

Adeola A Kosoko
Diego Craik Tobar

Publication Date

11-1-2022

Journal

Clinical Practice Cases Emergency Medicine

Abstract

INTRODUCTION: Infantile hypertrophic pyloric stenosis (IHPS) is a common cause of infant vomiting. Emergency department (ED) diagnosis is usually made by pyloric ultrasound and treated by pyloromyotomy.

CASE REPORT: An eight-week-old boy with a history of IHPS about six weeks status post pyloromyotomy presented to the ED with vomiting and failure to thrive, and a critically narrowed pylorus was identified by ultrasound. An upper gastrointestinal series confirmed recurrent pyloric stenosis, necessitating another pyloromyotomy.

CONCLUSION: Prolonged vomiting after pyloromyotomy should be concerning for recurrent IHPS. Upper gastrointestinal series should augment ultrasound to diagnose recurrent IHPS and determine whether a second pyloromyotomy is warranted.

Keywords

pyloric stenosis, vomiting, surgical failure, case report

DOI

10.5811/cpcem.2022.8.57140

PMID

36427034

PMCID

PMC9697887

PubMedCentral® Posted Date

October 2022

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes