Peculiar type 1 congenital pyloric atresia: a case report

Abstract

Pyloric atresia (PA) is a very rare condition. Its incidence is approximately 1 in 100,000 newborns and constitutes about 1% of all intestinal atresias. We describe the neonatal course of a peculiar case of type 1 pyloric atresia, in which the pyloric membrane was connected to a second duodenal membrane through a virtual duodenal lumen in a premature newborn. The atypical variant required an unusual side to side gastroduodenostomy. We emphasize the importance of a prompt diagnosis to avoid potentially fatal complications and to warrant a good outcome even in the presence of a strange form of PA in the neonatal period.

Congenital Pyloric Atresia

“…Incidence varies approximately 1 in 100000 live births. [ 1 2 ] It is a developmental error. Many hypotheses have been proposed to explain its occurrence ranging from noncanalization to intrauterine vascular accident.…”

Pyloric Atresia Type II

“…Type 1 -Pyloric membrane (57%) Type 2 -Pyloric tissue replaced by solid tissue (34%) Type 3 -Atretic pylorus with a gap between stomach and duodenum (9%) Surgical intervention with appropriate procedure as per the type of pyloric atresia is the treatment for this condition. The mortality depends on the post-operative care of the neonates and co-existing morbidities and anomalies, which could be as high as 50% [20].…”

Pyloric Atresia

“…The longitudinal pyloromyotomy is closed longitudinally [5]. (iii) A side to side gastroduodenostomy has been described too [6].…”