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Recurrent pyloric stenosis: to dilate or operate? A preliminary report
Ahmed Nasr1, Sigmund H Ein, Bairbre Connolly
1The Division of General Surgery and The Department of Interventional Radiology, The Hospital for Sick Children, Toronto, Ontario, Canada, M5G 1X8.
Purpose:
Idiopathic hypertrophic pyloric stenosis is a common surgical problem in infants, and pyloromyotomy is almost always successful in alleviating the obstruction. There are few reports in the literature that discuss recurrent pyloric stenosis as opposed to incomplete pyloromyotomy. We report 2 such babies with different cures.
Methods:
The health records department files were electronically searched for the number of infants at our children's hospital with hypertrophic pyloric stenosis seen over the past 30 years (1973-2003), and the recurrences were reviewed.
Results:
Recurrent pyloric stenosis was encountered in 2 cases (<0.07%). Balloon dilatation was first tried in both cases and was successful in 1 case; redo pyloromyotomy was required for the second case.
Conclusion:
Recurrent pyloric stenosis is rare. Fluoroscopic balloon dilatation of the pylorus warrants further study as the first choice for curing this problem, and if unsuccessful, redo pyloromyotomy.
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