Hypertrophic pyloric stenosis in a toddler: An atypical presentation in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria

Abstract

Gastric outlet obstruction resulting from hypertrophic pyloric stenosis typically manifests in early infancy and seldom occurs after this period. The case is a 14-month-old toddler with multiple episodes of nonbilious, projectile vomiting with persistent hunger, and progressive weight loss for three weeks. The symptoms were preceded by ingestion of a water-based herbal concoction. His barium meal and abdominal ultrasonographic findings were diagnostic of hypertrophic pyloric stenosis (HPS), following which he had an initial pyloromyotomy, which failed before he later had pyloroplasty. The patient was subsequently discharged home four days after the second surgery and has remained stable since then. Although hypertrophic pyloric stenosis is uncommon beyond early infancy, it should be suspected in toddlers with persistent postprandial vomiting that is projectile and nonbilious. Early diagnosis is essential to limit malnutrition as well as other complications associated with HPS.