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Recurrent Infantile Hypertrophic Pyloric Stenosis in the Emergency Department: A Case Report
Adeola A Kosoko1, Diego Craik Tobar1
1The University of Texas Health Sciences Center at Houston, McGovern Medical School, Houston, Texas.
Introduction:
Infantile hypertrophic pyloric stenosis (IHPS) is a common cause of infant vomiting. Emergency department (ED) diagnosis is usually made by pyloric ultrasound and treated by pyloromyotomy.
Case Report:
An eight-week-old boy with a history of IHPS about six weeks status post pyloromyotomy presented to the ED with vomiting and failure to thrive, and a critically narrowed pylorus was identified by ultrasound. An upper gastrointestinal series confirmed recurrent pyloric stenosis, necessitating another pyloromyotomy.
Conclusion:
Prolonged vomiting after pyloromyotomy should be concerning for recurrent IHPS. Upper gastrointestinal series should augment ultrasound to diagnose recurrent IHPS and determine whether a second pyloromyotomy is warranted.
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