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Hypertrophic Pyloric Stenosis in an Adolescent Girl: An Atypical Presentation of an Unexpected Disease

Hypertrophic pyloric stenosis is a common cause of vomiting in the first few weeks of life, but in rare cases, it may occur in older subjects with a major risk of delayed diagnosis and complications. We describe the case of a 12-year-and-8-month-old girl who presented to our department for epigastri...

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Autores principales: Gatti, Simona, Piloni, Francesca, Bindi, Edoardo, Cruccetti, Alba, Catassi, Carlo, Cobellis, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9944443/
https://www.ncbi.nlm.nih.gov/pubmed/36810533
http://dx.doi.org/10.3390/diseases11010019
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author Gatti, Simona
Piloni, Francesca
Bindi, Edoardo
Cruccetti, Alba
Catassi, Carlo
Cobellis, Giovanni
author_facet Gatti, Simona
Piloni, Francesca
Bindi, Edoardo
Cruccetti, Alba
Catassi, Carlo
Cobellis, Giovanni
author_sort Gatti, Simona
collection PubMed
description Hypertrophic pyloric stenosis is a common cause of vomiting in the first few weeks of life, but in rare cases, it may occur in older subjects with a major risk of delayed diagnosis and complications. We describe the case of a 12-year-and-8-month-old girl who presented to our department for epigastric pain, coffee-ground emesis, and melena, which arose after taking ketoprofen. An abdomen ultrasound showed thickening (1 cm) of the gastric pyloric antrum, while upper-GI endoscopy documented esophagitis and antral gastritis with a non-bleeding pyloric ulcer. During her hospital stay, she had no further episodes of vomiting and was therefore discharged with a diagnosis of “NSAIDs-induced acute upper gastrointestinal tract bleeding”. After 14 days, following recurrence of abdominal pain and vomiting, she was hospitalized again. At endoscopy, pyloric sub-stenosis was found, abdominal CT showed thickening of large gastric curvature and pyloric walls, and an Rx barium study documented delayed gastric emptying. On suspicion of idiopathic hypertrophic pyloric stenosis, she underwent Heineke–Mikulicz pyloroplasty with resolution of symptoms and restoration of a regular caliber of the pylorus. Hypertrophic pyloric stenosis, although occurring rarely in older children, should be taken into account in the differential diagnosis of recurrent vomiting at any age.
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spelling pubmed-99444432023-02-23 Hypertrophic Pyloric Stenosis in an Adolescent Girl: An Atypical Presentation of an Unexpected Disease Gatti, Simona Piloni, Francesca Bindi, Edoardo Cruccetti, Alba Catassi, Carlo Cobellis, Giovanni Diseases Case Report Hypertrophic pyloric stenosis is a common cause of vomiting in the first few weeks of life, but in rare cases, it may occur in older subjects with a major risk of delayed diagnosis and complications. We describe the case of a 12-year-and-8-month-old girl who presented to our department for epigastric pain, coffee-ground emesis, and melena, which arose after taking ketoprofen. An abdomen ultrasound showed thickening (1 cm) of the gastric pyloric antrum, while upper-GI endoscopy documented esophagitis and antral gastritis with a non-bleeding pyloric ulcer. During her hospital stay, she had no further episodes of vomiting and was therefore discharged with a diagnosis of “NSAIDs-induced acute upper gastrointestinal tract bleeding”. After 14 days, following recurrence of abdominal pain and vomiting, she was hospitalized again. At endoscopy, pyloric sub-stenosis was found, abdominal CT showed thickening of large gastric curvature and pyloric walls, and an Rx barium study documented delayed gastric emptying. On suspicion of idiopathic hypertrophic pyloric stenosis, she underwent Heineke–Mikulicz pyloroplasty with resolution of symptoms and restoration of a regular caliber of the pylorus. Hypertrophic pyloric stenosis, although occurring rarely in older children, should be taken into account in the differential diagnosis of recurrent vomiting at any age. MDPI 2023-01-28 /pmc/articles/PMC9944443/ /pubmed/36810533 http://dx.doi.org/10.3390/diseases11010019 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Gatti, Simona
Piloni, Francesca
Bindi, Edoardo
Cruccetti, Alba
Catassi, Carlo
Cobellis, Giovanni
Hypertrophic Pyloric Stenosis in an Adolescent Girl: An Atypical Presentation of an Unexpected Disease
title Hypertrophic Pyloric Stenosis in an Adolescent Girl: An Atypical Presentation of an Unexpected Disease
title_full Hypertrophic Pyloric Stenosis in an Adolescent Girl: An Atypical Presentation of an Unexpected Disease
title_fullStr Hypertrophic Pyloric Stenosis in an Adolescent Girl: An Atypical Presentation of an Unexpected Disease
title_full_unstemmed Hypertrophic Pyloric Stenosis in an Adolescent Girl: An Atypical Presentation of an Unexpected Disease
title_short Hypertrophic Pyloric Stenosis in an Adolescent Girl: An Atypical Presentation of an Unexpected Disease
title_sort hypertrophic pyloric stenosis in an adolescent girl: an atypical presentation of an unexpected disease
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9944443/
https://www.ncbi.nlm.nih.gov/pubmed/36810533
http://dx.doi.org/10.3390/diseases11010019
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