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Infantile hypertrophic pyloric stenosis in a 5-month-old baby: case report

M M Tiao1, H C Huang, C S Shieh

  • 1Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, R.O.C. tiaul@tpts8.seed.net.tw

Chang Gung Medical Journal
|September 7, 2000
PubMed

Insights

This case study reports the oldest diagnosed infant with hypertrophic pyloric stenosis in Taiwan at over 5 months old. Delayed diagnosis highlights the importance of advanced imaging for vomiting infants.

Area of Science:

  • Pediatric Surgery
  • Diagnostic Imaging
  • Gastroenterology

Background:

  • Infantile hypertrophic pyloric stenosis (IHPS) typically presents in neonates aged 2-4 weeks.
  • Delayed diagnosis of IHPS can lead to prolonged symptoms and complications.

Observation:

  • A 5-month-old boy presented with sudden onset vomiting, initially misdiagnosed as gastric volvulus.
  • Initial abdominal ultrasonography was negative, but a subsequent scan using a 7-MHz transducer identified a tubular pyloric mass.
  • No abdominal mass was palpable on physical examination.

Findings:

  • The pyloric mass measured 5.5 mm thickness, 15 mm transverse diameter, and 2.0 cm length.
  • This case represents the oldest reported infant diagnosed with IHPS in Taiwan.
  • The diagnosis was confirmed after the infant vomited, suggesting dynamic changes.

Implications:

  • This case underscores the possibility of IHPS presenting later than typically observed.
  • Advanced ultrasonography techniques may be crucial for diagnosing subtle cases of IHPS.
  • Increased awareness is needed for atypical presentations of IHPS in older infants.

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