Hypertrophic pyloric stenosis in an older child: a rare presentation with successful standard surgical management

Area of Science:

• Pediatric Gastroenterology
• Clinical Case Reports

Background:

• Infantile hypertrophic pyloric stenosis (IHPS) is a common neonatal surgical emergency.
• Typically presents within the first few months of life with non-bilious vomiting.
• Associated metabolic derangements like alkalosis and aciduria are well-documented.

Observation:

• An 8-year-old boy presented with a history of recurrent, long-standing non-bilious vomiting.
• The patient also exhibited poor weight gain.
• Notably, no significant metabolic abnormalities were detected during evaluation.

Findings:

• This case represents a rare, late-onset presentation of infantile hypertrophic pyloric stenosis.
• The absence of typical metabolic sequelae in this older child is unusual.
• Diagnostic challenges in atypical presentations of IHPS.

Implications:

• Suggests that IHPS may have atypical presentations beyond the neonatal period.
• Highlights the importance of considering IHPS in older children with unexplained vomiting and poor weight gain.
• Underscores the need for thorough diagnostic evaluation in suspected cases, even without classic symptoms.