تنگی هایپرتروفیک پیلور، علت استفراغ های غیر صفراوی نوزاد پسر 3 روزه با سایتوس اینورسوس توتالیس; گزارش موردی

عنوان انگليسی

Infantile Hypertrophic Pyloric Stenosis, the Cause of Non-bilious Vomiting of a 3-day-old Male Infant with Situs Inversus Totalis; A Case Report

خلاصه انگلیسی

A 3-day-old term infant result of natural delivery weighing 2200 gr underwent pediatric surgery service consulting on his second day of life because of non-bilious vomiting. The ultrasonography revealed the pyloric canal is 22 mm in length and 4 mm in width without abdominal anomalies, but an incidental finding was the mirror displacement of the viscera. Echocardiography for preoperative preparation demonstrated dextrocardia. So, the diagnosis of situs inversus totalis was confirmed. For the rarity of HPS diagnosis on the third day, an upper Gastrointestinal series was performed where there was no evidence of malrotation or midgut volvulus. Barium enema ruled out intestinal atresia. A transverse supraumbilical incision leaning to the left created space for the operation. The pylorus was located at the left. The thickness zone was obviously visible in the pyloric region that was capable with the ultrasonography report. The classic pyloromyotomy was done. Then the route by passing the air through the nasogastric tube during the surgery was tested. Four hours after surgery, feeding with sugar water was initiated, then formula. He was discharged after a day from the hospital with improvement. The postoperative and 3-month follow-up periods were uneventful, and his growth charts were in normal ranges. Vomiting in a newborn is serious, even if it is non-bilious. It needs careful evaluation. Although IHPS is the disorder of infants generally aged three weeks to 3 months, it may rarely be seen in the early days of life. However, extremely rare, it seems that SIT can be associated with gastrointestinal disorders such as IHPS.

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