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Gastric outlet obstruction after long-term prostaglandin administration mimicking hypertrophic pyloric stenosis

M Lacher1, K Schneider, R Dalla Pozza

  • 1Kinderchirurgische Klinik im Dr. von Haunerschen Kinderspital, Ludwig-Maximilians-Universität München, Munich, Germany. Martin.Lacher@med.uni-muenchen.de

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|October 31, 2007
PubMed

Insights

Prostaglandin E1 (PGE1) therapy in neonates can cause gastric outlet obstruction, mimicking pyloric stenosis. Symptoms resolve after discontinuing PGE1 and cardiac surgery.

Area of Science:

  • Neonatal cardiology
  • Pediatric gastroenterology
  • Pharmacology

Background:

  • Prostaglandin E1 (PGE1) is crucial for neonates with cyanotic congenital heart disease requiring ductal patency.
  • Common PGE1 side effects include respiratory, cardiovascular, and neurological issues, but gastrointestinal effects are less understood.

Observation:

  • A case report details an infant experiencing feeding difficulties and projectile vomiting at one month of age.
  • Sonography revealed progressive antropyloric channel elongation causing gastric outlet obstruction, without pyloric wall thickening.

Findings:

  • The infant's symptoms resolved within three days of cardiac surgery and cessation of PGE1 therapy, with normal feeding and weight gain.
  • The observed sonographic findings of gastric outlet obstruction can be mistaken for hypertrophic pyloric stenosis.

Implications:

  • This case highlights a rare gastrointestinal side effect of long-term PGE1 administration in neonates.
  • Accurate diagnosis is crucial to differentiate PGE1-induced gastric outlet obstruction from hypertrophic pyloric stenosis, avoiding unnecessary surgical intervention.

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