Late-onset hypertrophic pyloric stenosis with gastric outlet obstruction: case report and review of the literature

We report late-onset hypertrophic pyloric stenosis in a 17-year-old female. She presented with abdominal pain and an episode of upper gastrointestinal hemorrhage and subsequently developed gastric outlet obstruction. Work-up revealed circumferential pyloric thickening, delayed gastric emptying, and...

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Bibliographic Details
Published in:Pediatric surgery international 2016-10, Vol.32 (10), p.1013-1016
Main Authors: Wolf, Lindsey L., Nijagal, Amar, Flores, Alejandro, Buchmiller, Terry L.
Format: Article
Language:English
Subjects:
Abdominal Pain - etiology
Abdominal Pain - surgery
Adolescent
Case Report
Female
Follow-Up Studies
Gastric Outlet Obstruction - complications
Gastric Outlet Obstruction - surgery
Humans
Laparoscopy - adverse effects
Male
Medicine
Medicine & Public Health
Pediatric Surgery
Pediatrics
Pyloric Stenosis, Hypertrophic - complications
Pyloric Stenosis, Hypertrophic - surgery
Pylorus - surgery
Surgery
Treatment Outcome
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Summary:We report late-onset hypertrophic pyloric stenosis in a 17-year-old female. She presented with abdominal pain and an episode of upper gastrointestinal hemorrhage and subsequently developed gastric outlet obstruction. Work-up revealed circumferential pyloric thickening, delayed gastric emptying, and a stenotic, elongated pyloric channel. Biopsies showed benign gastropathy, negative for Helicobacter pylori , without eosinophilic infiltrates. Botulinum toxin injection provided limited relief. Diagnostic laparoscopy confirmed the hypertrophic pylorus and we performed laparoscopic pyloromyotomy. The patient tolerated the procedure well and had complete symptom resolution at 1-year follow-up. Hypertrophic pyloric stenosis is a rare cause of gastric outlet obstruction in adolescents and may be managed successfully with laparoscopic pyloromyotomy.
ISSN:0179-0358
1437-9813
DOI:10.1007/s00383-016-3955-5