Chronic Form (Hypertrophic Pyloric Stenosis)

Operative findings in a 2.5-year-old boy with a 'chronic gastric outlet stenosis'. The toddler has had recurrent vomiting since the transition-time from the neonatal period to the second month of life until now. The very large stomach is retracted by two stay-sutures on the top. Between two retractors and in continuity with the stomach a longitudinal oval swelling is visible. It is a patient in whom a hypertophic pyloric stenosis as the cause of recurrent vomiting since early infancy was not detected until the age of a toddler. Due to a long-standing stenosis the stomach is secondarily distinctly dilated; $$regu_01??££see alternate picture.§§ The differentiation between various forms of hypertrophic pyloric stenosis can be made according to different aspect; e.g. according to the clinical course, such as time and speed of onset of the clinical signs, or the degree of obstacle. Or, according to the absence or presence of a simultaneous gastroesophageal reflux or other anomaly. The presented case is an atypical form. Hypertrophic pyloric stenosis may already occur in the neonate or beyond the usual preferred age. Considering the late diagnosis, the presented case must be classified as an atypical subtotal form which did not lead to a complete impossibility to feed as is usually the case, but allowed some food ingestion.