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Successful Treatment of Recurrent Pyloric Stenosis Using Balloon Dilation
Jesseca R A Pirkle1, David Deutsch1,2
1From the Department of Pediatric Gastroenterology, College of Medicine, University of Illinois, Rockford, IL.
Insights
Infantile hypertrophic pyloric stenosis (IHPS) is a common infant condition. Balloon dilation offers a new treatment option for rare recurrent IHPS cases after surgery.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Infantile hypertrophic pyloric stenosis (IHPS) affects 2-5/1000 infants, presenting with projectile vomiting and epigastric masses.
- Ramstedt pyloromyotomy is the standard surgical treatment for IHPS.
- Postoperative emesis can indicate incomplete or recurrent pyloric stenosis.
Observation:
- A rare case of recurrent IHPS occurred in an 8-week-old female infant 3.5 weeks post-laparoscopic pyloromyotomy.
- The infant presented with persistent postoperative emesis.
Findings:
- A successful balloon dilation procedure was performed for recurrent IHPS.
- This intervention resolved the infant's symptoms.
Implications:
- Balloon dilation presents a potential alternative treatment for recurrent pyloric stenosis.
- Further research is needed to establish balloon dilation as a standard of care for recurrent IHPS.
Abstract:
Infantile hypertrophic pyloric stenosis is a common surgical disease in infants, with an incidence of 2 to 5 cases per 1000 live births. It often presents with nonbilious projectile vomiting after feeding and a mid-epigastric mass in infants between the third and eighth weeks of life. Ramstedt pyloromyotomy remains the gold standard of treatment. Postoperative emesis is common; however, further evaluation for incomplete pyloromyotomy and recurrent pyloric stenosis should be conducted with prolonged, or new-onset postoperative emesis. While repeat pyloromyotomy is the standard of care for infants presenting with incomplete pyloric stenosis, treatment for the rare development of recurrent pyloric stenosis is not clearly outlined. Here, we report a successful balloon dilation procedure in an 8-week-old female with recurrent pyloric stenosis three and a half weeks after the initial laparoscopic pyloromyotomy.
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