Prenatally diagnosed congenital pyloric atresia in consecutive three siblings: a case report

Ryuta Saka1, Dan Yamamoto2, Seika Kuroda3

  • 1Department of Pediatric Surgery, National Hospital Organization Fukuyama Medical Center, 4-14-17 Okinogamicho, Fukuyama, Hiroshima, 720-8520, Japan. saka@pedsurg.med.osaka-u.ac.jp.

Surgical Case Reports
|January 7, 2021
PubMed

Insights

Congenital pyloric atresia (CPA) is a rare condition diagnosed prenatally via ultrasound. Timely diagnosis and surgical intervention lead to healthy outcomes for affected infants.

Area of Science:

  • Pediatric Surgery
  • Neonatal Medicine
  • Gastroenterology

Background:

  • Congenital pyloric atresia (CPA) is a rare gastrointestinal anomaly.
  • CPA is often associated with epidermolysis bullosa (EB).
  • Delayed diagnosis of isolated CPA can lead to increased morbidity.

Purpose of the Study:

  • To report on a familial case of congenital pyloric atresia.
  • To highlight the utility of prenatal diagnosis in managing CPA.
  • To demonstrate successful surgical outcomes in infants with CPA.

Main Methods:

  • Case presentation of three female siblings diagnosed with CPA prenatally.
  • Prenatal diagnosis was based on ultrasound findings (polyhydramnios, dilated stomach).
  • Surgical reconstruction included pyloromyotomy and various gastroduodenostomy techniques.

Main Results:

  • All three infants had an uneventful postoperative course.
  • The siblings experienced healthy growth without complications.
  • Prenatal diagnosis facilitated timely postnatal surgical intervention.

Conclusions:

  • Fetal ultrasonography is a valuable tool for prenatal diagnosis of CPA.
  • Early detection through prenatal imaging enables prompt surgical management.
  • Successful outcomes are achievable with timely intervention for congenital pyloric atresia.
Abstract

Related Concept Videos

Esophageal Perforation-I: Introduction01:22

Esophageal Perforation-I: Introduction

Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
Esophageal Perforation-II: Clinical Manifestations and Management01:28

Esophageal Perforation-II: Clinical Manifestations and Management

Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Pyloric Obstruction01:11

Pyloric Obstruction

Pyloric obstruction, also referred to as gastric outlet obstruction, is a condition characterized by narrowing or blockage at the pylorus—the muscular valve regulating the flow of stomach contents into the duodenum. When this passage becomes impaired, the stomach cannot effectively empty its contents into the small intestine. This disruption leads to a range of gastrointestinal symptoms, including early satiety, bloating, epigastric pain, postprandial nausea, persistent vomiting, and...