Pyloric Stenosis Complicating Esophageal Atresia

authors:

avatar S Jahanshahifard 1 , * , avatar M Ahmadpour-Kacho 1 , avatar MR Esmaeili Dooki 2 , avatar S Osia 3 , avatar A Hadipoor 3 , avatar Y Zahedpasha 1

Sections of Neonatology
Gastroenterology, Department of Pediatrics
Department of Pediatric Surgery, Non-Communicable Pediatric Disease Research Cen-ter, Babol University of Medical Sciences, Amirkola Children Hospital, , Iran

how to cite: Jahanshahifard S, Ahmadpour-Kacho M, Esmaeili Dooki M, Osia S, Hadipoor A, et al. Pyloric Stenosis Complicating Esophageal Atresia. Shiraz E-Med J. 2011;12(1): 44-47. 

Abstract

Abstract:

Background: Post surgical complications of esophageal atresia (EA) include anastomotic leak, anastomotic stricture, gastroesophageal reflux, tracheomalacia, and recurrent tra-cheoesophageal fistula (TEF). However, hypertrophic pyloric stenosis (HPS) is complicating EA which seems to be rare. The aim of this report is to emphasize on HPS as a possible complicating post operative course of EA, the diagnosis of this complicating disorder may be delayed. Case presentation: A 3000 gram male infant was born at 38 weeks gestation to a 21-year-old, gravid mother by cesarean section. He presented vomiting with profuse foamy dis-charge and salivation. Esophageal atresia was confirmed by looped orogastric tube in the upper pouch of esophagus in chest X-ray. He underwent surgical correction and was discharged with a good condition on 7th post operation day. Nevertheless three weeks later, he developed recurrent vomiting. The diagnosis of HPS was confirmed by ultraso-nography and barium upper gastrointestinal (GI) series. Pyloromyotomy was done on him and He was discharged without any complication. At 3.5 months old, he developed regur-gitation and chocking cyanosis. At this time esophageal stenosis was diagnosed by bari-um swallow. The stricture was treated by gastroduodenoscopy. Conclusion: Infantile HPS should be considered in any case of persistent vomiting and feeding intolerance after surgery for esophageal atresia. A high index of suspicion is re-quired for diagnosis to avoid complication arising from a delayed diagnosis.

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