Abstract / Summary
: Introduction Pyloric atresia is a rare cause of neonatal gastric outlet obstruction, accounting for less than 1% of intestinal atresias, with an estimated incidence of 1 in 100,000 live births. Case Presentation A female infant was delivered at early term for severe polyhydramnios without other abnormalities seen. Frequent nonbilious emesis and failure to pass meconium by 35 hours of life prompted neonatal intensive care unit admission. Abdominal radiography demonstrated a distended stomach with absence of distal bowel gas. An upper gastrointestinal contrast study showed persistent retention of contrast within the stomach, while contrast enema excluded distal intestinal obstruction. Ultrasonography demonstrated a bandlike structure obstructing the pyloric channel, raising suspicion for pyloric atresia. Exploratory laparotomy confirmed an isolated type I pyloric atresia caused by an obstructing pyloric membrane, with no additional intestinal atresias identified. The membrane was excised and a Heineke-Mikulicz pyloroplasty performed. Enteral feeding was initiated on postoperative day five after contrast imaging confirmed gastrointestinal continuity without leak. The infant was discharged on postoperative day 11 and remains well at follow-up. Conclusion Pyloric atresia should be suspected in newborns who have signs of gastric outlet obstruction. Ultrasound may be helpful in distinguishing pyloric atresia from other causes of gastric outlet obstruction.