RAREST AMONG THE RARE - PYLORIC ATRESIA - A CASE SERIES

Volume : VII, Issue : VIII, August - 2018

Dr D Vembar, Dr V Rohit Gopinath, Prof J Muthukumaran

Gastric outlet obstruction in a neonate can occur due to several aetiologies. Here I am presenting 4 cases of the same. 1 is a case

of a 4 days old male child who was ought with complaints of persistent non bilious vomiting since D1 of life. Examination

revealed the presence of visible gastric peristalsis. X ray abdomen done showed the presence of a dilated stomach with absent

distal gas shadow. USG abdomen done showed normal SMV SMA axis. Intraoperatively a type B pyloric atresia was noted for

nd which a gastroduodenostomy was done. Post operative period was uneventful and the child was discharged on POD 8. 2 is a

case of a 12 days old male child who was admitted with complaints of respiratory distress and was intubated for the same .Child

was extubated on day 10 and was started on oral feeds, following which the child had persistent vomiting which was non bilious .

X ray abdomen taken showed a dilated stomach with paucity of distal gas shadow. Barium meal follow through done showed

stasis of contrast in the stomach even in 6 hrs. Child was taken up for a laparotomy and was found to have a type A pyloric atresia.

Gastrotomy was done and the memane was excised. Post op child continued to have vomiting and underwent a repeat barium

study which showed stasis in the stomach. Child was then taken up for a laparotomy and a gastrojejunostomy was done. Child

was discharged and is on follow up. Among the entire spectrum of anomalies causing GOO, pyloric atresia is a very rare condition

(1 in 100,000 newborns) Successful management is dependent on the early recognition of the entity and appropriate surgical

intervention, optimum post–operative care and absence of associated anomalies.