Pyloric Stenosis Complicating Esophageal Atresia

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.