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Late-Onset Hypertrophic Pyloric Stenosis in a 14-Weeks-Old Full Term Male Infant

Zenon Pogorelić1,2, Ivana Čulo Čagalj3, Vanda Žitko3

  • 1Department of Pediatric Surgery, University Hospital of Split, Split, Croatia. zpogorelic@gmail.com.

Acta Medica (Hradec Kralove)
|August 1, 2019
PubMed

Insights

Hypertrophic pyloric stenosis (HPS) is rare in infants older than 6 weeks. This case highlights HPS in a 14-week-old infant presenting with vomiting, emphasizing HPS as a differential diagnosis in older infants.

Area of Science:

  • Pediatric Surgery
  • Neonatal Gastroenterology

Background:

  • Hypertrophic pyloric stenosis (HPS) is the leading cause of gastric outlet obstruction in infants.
  • Typical presentation is between 2 to 6 weeks of age.

Observation:

  • A 14-week-old male infant presented with non-bilious vomiting, dehydration, and hypochloremic metabolic alkalosis.
  • Abdominal ultrasonography showed a 20 mm tubular mass, and diagnosis was confirmed with an upper gastrointestinal contrast study due to the patient's unusual age.

Findings:

  • Laparoscopic pyloromyotomy was successfully performed.
  • The infant recovered fully, gaining weight and tolerating a regular diet post-surgery.

Implications:

  • Hypertrophic pyloric stenosis should be considered in infants presenting with non-bilious vomiting, regardless of age.
  • This case underscores the importance of considering HPS even in delayed presentations beyond the typical neonatal period.
Abstract

Keywords:
childrenhypertrophic pyloric stenosisinfantslate presentationnon-bilious vomiting

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