Pyloric atresia

A rare case in a newborn 48hrs old male baby. baby was intubated within 2hrs of birth in view of respiratory distress. abdominal distension was noted. infant tube was inserted. nil aspirate. xray abdomen taken showed dilated stomach with distal obstruction. abdomen distension was persistent and progressive and baby did not passed meconium. clinically palpable gastric mass was noted. suspecting duodenal atresia posted the child for exploratory laparotomy. intraoperative findings: dilated stomach, duodenum normal no dilatation, small n large bowel normal. on bowel walkin no thickenin noted in the duodenum. small distal gastrostomy above the antrum was done and infant tube was attempted to negotiate distally but failed.. resistance was observed. suspected pyloric atresia and proceeded with gastrojejunostomy with feeding jejunostomy. postoperatively child was strted on feeds on pod 6 with 5ml 3rd and gradually increased the feeds n at pod 16 child was strted on direct breast feed. at present child stable and tolerating feeds and gainin weight. kindly give ur ideas and opinion on this case and its treatment approach.



Commandable job. Keep it up

Thank u sir

Congrats on the successful management of the case.. Few queries are.. How come no vomiting or aspirates in upper GI obstruction.. Was septic ileus ruled out..what was the potassium.Is there any associated anomaly as seen in congenital pyloric stenosis like epidermolysis bullosa, sensorineural deafness etc. And lastly what is the further plan for feeding jejunostomy.

Yes blood parameters wer al within limits.. No associated anomaly noted at present. Feeding jejunoastomy was to strt on early enteral feeds.

Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

It may b congeital hypertrophic pyloric stenosis Pyloroplasty is tteatment

Sir in that case feeding tube should hav been negotiable ryt..

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Great job Dr Shifa zareena

Thank you doctor