Unusual late‐onset hypertrophic pyloric stenosis in an adolescent girl with down syndrome: Case report and review of the literature

A 16‐year‐old girl with down syndrome came to our attention for recurrent postprandial vomiting and significant weight loss (>5 kgs). Diagnostic assessment (barium swallow study, ultrasonography, and CT) confirmed hypertrophic pyloric stenosis (HPS). Initial attempt with endoscopic dilation was n...

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Bibliographic Details
Published in:Journal of clinical ultrasound 2024-11, Vol.52 (9), p.1456-1462
Main Authors: Chiodi, Annalisa, Escolino, Maria, Di Mento, Claudia, Salvati, Vincenzo, Mazzone, Valerio, Esposito, Giorgia, Porcaro, Mauro, Esposito, Ciro
Format: Article
Language:English
Subjects:
Adolescent
Adolescents
Barium
Computed tomography
Diagnosis
Diagnosis, Differential
Diagnostic systems
Differential diagnosis
down syndrome
Down Syndrome - complications
Down's syndrome
Endoscopy
Eutrophication
Female
Humans
hypertrophic pyloric stenosis
Literature reviews
Pyloric Stenosis, Hypertrophic - complications
Pyloric Stenosis, Hypertrophic - diagnostic imaging
Pyloric Stenosis, Hypertrophic - surgery
pyloroplasty
Stenosis
Ultrasonography - methods
Vomiting
Weight loss
Citations: Items that this one cites
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Summary:A 16‐year‐old girl with down syndrome came to our attention for recurrent postprandial vomiting and significant weight loss (>5 kgs). Diagnostic assessment (barium swallow study, ultrasonography, and CT) confirmed hypertrophic pyloric stenosis (HPS). Initial attempt with endoscopic dilation was not successful. The patient underwent Heineke–Mikulicz pyloroplasty. Full oral feeding was achieved by Day 7 postoperatively. At 6‐month follow‐up, the patient reported relief of symptoms, normal feeding habits and substantial weight gain. HPS should be considered in the differential diagnosis of recurrent vomiting, regardless of age. A comprehensive diagnostic work‐up, including ultrasonography, endoscopy, and CT, is recommended to confirm the diagnosis. Although typically observed during the neonatal period, hypertrophic pyloric stenosis may occur in adolescence. A comprehensive diagnostic work‐up, including ultrasonography, upper GI endoscopy, and CT, is recommended to confirm the diagnosis. If the endoscopic approach proves unsuccessful, Heineke–Mikulicz pyloroplasty can serve as safe and effective alternative treatment option.
ISSN:0091-2751
1097-0096
1097-0096
DOI:10.1002/jcu.23777