Postoperative gastric outlet obstruction following hiatal hernia repair in an infant: A case report

Authors

  • Muhammad Jawad Afzal Department of Paediatric Surgery Unit-II, The Childrens Hospital and The Institute of Child Health, Lahore
  • Shabbir Ahmad Department of Pediatric Surgery Unit-II, The Children’s Hospital & the Institute of Child Health, Lahore
  • Farrakh Mehmood Satar Department of Paediatric Surgery Unit-II, The Childrens Hospital and The Institute of Child Health, Lahore
  • Sajid Iqbal Nayyer Department of Paediatric Surgery Unit-II, The Childrens Hospital and The Institute of Child Health, Lahore
  • Muhammad Bilal Mirza Department of Paediatric Surgery Unit-II, The Childrens Hospital and The Institute of Child Health, Lahore
  • Nabila Talat Department of Paediatric Surgery Unit-II, The Childrens Hospital and The Institute of Child Health, Lahore

DOI:

https://doi.org/10.46831/jpas.v1i2.39

Keywords:

Hiatal hernia, Infantile hypertrophic pyloric stenosis, Postoperative emesis, Gastric outlet obstruction

Abstract

Background: Infantile hypertrophic pyloric stenosis (IHPS) is an exceedingly rare cause of postoperative emesis in a case of hiatal hernia. Occasionally it may simulate other etiology of gastric outlet obstruction.

Case Presentation: A 32-day-old male baby presented with respiratory distress and vomiting since birth. Diagnosis of eventration of left hemi diaphragm was made on CT Chest. At surgery, hiatal hernia with an intrathoracic stomach was found, which was repaired. On 5th postoperative day, the baby developed vomiting after feeding which gradually turned to be projectile in nature over a week. Contrast meal performed showed malpositioned stomach with delayed emptying. At re-operation, a well-formed olive of pylorus was encountered; Ramstedt pyloromyotomy was done. Postoperative course remained uneventful.

Conclusion: IHPS is a rarely described association with hiatal hernia. Pyloric stenosis should be considered in differential diagnoses of postoperative emesis in infants with hiatal hernia.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Author Biographies

Muhammad Jawad Afzal, Department of Paediatric Surgery Unit-II, The Childrens Hospital and The Institute of Child Health, Lahore

Resident 

Shabbir Ahmad, Department of Pediatric Surgery Unit-II, The Children’s Hospital & the Institute of Child Health, Lahore

Senior Registrar 

Farrakh Mehmood Satar, Department of Paediatric Surgery Unit-II, The Childrens Hospital and The Institute of Child Health, Lahore

Senior Registrar 

Sajid Iqbal Nayyer, Department of Paediatric Surgery Unit-II, The Childrens Hospital and The Institute of Child Health, Lahore

Senior Registrar 

Muhammad Bilal Mirza, Department of Paediatric Surgery Unit-II, The Childrens Hospital and The Institute of Child Health, Lahore

Assistant Professor 

Nabila Talat, Department of Paediatric Surgery Unit-II, The Childrens Hospital and The Institute of Child Health, Lahore

Professor/Head Department of Paediatric Surgery Unit-II

References

Kohn GP, Price RR, Demeester SR, Zehetner J, Muensterer OJ, Awad ZT, et al. Guidelines for the management of hiatal hernia - A SAGES publication. SAGES [Internet]. 2013 [cited 2020 Jun 19]; Available from: https://www.sages.org/publications/guidelines/guidelines-for-the-management-of-hiatal-hernia/

Müller-Stich BP, Achtstätter V, Diener MK, Gondan M, Warschkow R, Marra F, et al. Repair of paraesophageal hiatal hernias-is a fundoplication needed? A randomized controlled pilot trial. J Am Coll Surg. 2015; 221:602–10.

Iijima T, Okamatsu T, Matsumura M, Yatsuzuka M. Hypertrophic pyloric stenosis associated with hiatal hernia. J Pediatr Surg. 1996; 31:277–9.

Keet AD. Hiatus hernia and the pyloric sphincteric cylinder. In: The Pyloric Sphincteric Cylinder in Health and Disease. Berlin, Heidelberg: Springer Berlin Heidelberg; 1993. p. 325–39.

Redman M, Ross DA. Hypertrophic pyloric stenosis following repair of congenital diaphragmatic hernia. J Pediatr Surg. 1979; 14:607.

Winckworth LC, Rees CM, Fan T, Haddad M, Clarke SA. Pyloric stenosis in an iniencephalic infant with a congenital intra-thoracic stomach. Pediatr Surg Int [Internet]. 2009 Oct 2 [cited 2020 Jun 18];25(10):907–9. Available from: http://link.springer.com/10.1007/s00383-009-2479-7

Published

2021-01-20

How to Cite

1.
Afzal MJ, Ahmad S, Mehmood Satar F, Nayyer SI, Mirza MB, Talat N. Postoperative gastric outlet obstruction following hiatal hernia repair in an infant: A case report. J Pediatr Adolesc Surg [Internet]. 2021Jan.20 [cited 2021Oct.18];1(2):89-91. Available from: http://jpedas.org/ojs/index.php/jpedas/article/view/jpas-39
Share |

Most read articles by the same author(s)