A Rare Cause of Prolonged Jaundice-Infantile Hypertrophic Pyloric Stenosis: A Case Report

Abstract

Abstract Introduction: Infantile hypertrophic pyloric stenosis is a disorder that causes a near-complete occlusion of the gastric outflow and leads to forceful vomiting in young infants. The congenital anomaly classically presents as being a dehydrated and underweight infant with several electrolyte abnormalities. Prolonged jaundice is an entity that has been described as total bilirubinemia (> 8 mg/dl) persisting beyond 14–21 postnatal days in newborns. The underlying etiologies of prolonged jaundice is generally as follows breast milk, congenital hypothyroidism, urinary tract infection, hemolysis and congenital methabolic disorders. Prolonged jaundice caused by Infantile hypertrophic pyloric stenosis has been extremely rare reported in the literature. Case Presentation: A 33-day-old boy presented with acute onset non-projectile vomiting and prolonged jaundice. The common etiological factor of prolonged jaundice alongside non-projectile vomiting has been evaluated and the laboratory markers for hypothyroidism, urinary tract infection or hemolysis have not been detected. Although there was no failure to thrive, projectile vomiting, and pathological laboratory results; other rare etiologies of prolonged jaundice was analyzed and finally the ultrasonographic imaging showed a positive for infantile hypertrophic pyloric stenosis. The case was operated on with the technique of Ramstedt pyloromyotomy, recovered uneventfully, and jaundice regressed. Conclusions: Albeit breastmilk jaundice is the most common cause of prolonged jaundice; the radiological investigations should not be delayed for the correct diagnosis of infants presented with vomiting that could be associated with the possibility of less definite clinical features of infantile hypertrophic pyloric stenosis.