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Is hypertrophic pyloric stenosis a secondary disease?
Fariba Tabrizian Namini1, Seyed Mohammad Ali Raisolsadat, Fateme Omid
1Department of General Pediatric Surgery, 22 Bahman Hospital, Islamic Azad University of Mashhad, Iran.
Insights
Hypertrophic pyloric stenosis (HPS) in infants can present congenitally. This study highlights three cases of HPS presenting on the first day of life with other gastrointestinal anomalies, suggesting a link to distal obstructions.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Neonatal Medicine
Background:
- Hypertrophic pyloric stenosis (HPS) is a common infant gastrointestinal obstruction requiring surgical intervention.
- Typical HPS presentation occurs between 4-6 weeks of life, but congenital or earlier onset is possible.
Observation:
- This report details three cases of HPS presenting within the first day of life.
- These cases were characterized by co-existing malrotation, annular pancreas, and duodenal atresia.
Findings:
- The presence of distal obstructions alongside early-onset HPS suggests a potential role in its pathogenesis.
- These co-existing anomalies may exacerbate factors leading to congenital or very early HPS.
Implications:
- The findings suggest that distal intestinal obstructions should be considered in the etiology of congenital or very early-onset HPS.
- Early identification of distal obstructions may be crucial for managing HPS presenting congenitally or within the first day of life.
Abstract:
Hypertrophic pyloric stenosis (HPS) is the most common gastrointestinal obstructive disease in infants which requires surgery. Typical presentation is at 4-6 weeks of life but can present very earlier or congenitally. Here we present 3 cases of HPS which presented in the first day of life with co-existing malrotation, annular pancreas, and duodenal atresia. The exact etiology of HPS is not fully understood, however, genetic and maternal factors, hormonal factors, abnormalities of various components of the pyloric muscle, growth factors, extracellular matrix elements, nerve and ganglion cells synapses, nerve supporting cells, neurotransmitters and interstitial cells, drugs, and feeding have been implicated. In the HPS concomitant with a distal obstruction, mean that these obstructions may role in pathogenesis of HPS or may exacerbate other factors to produce HPS in a very early age or congenitally. The purpose of this manuscript is to present three cases of HPS in the first day of life with other GI anomalies. We hypothesize that the etiology of some cases of HPS may be secondary to distal intestinal obstructions especially when it presents very early in life, or at least to concern a distal obstructions in this very early presentation.
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