A Case of Primary Acquired Gastric Outlet Obstruction in Late Infancy and Childhood.

PRESENTATION: We report a case of a 20-month-old who presented with a 3-week history of non-bilious vomiting and metabolic alkalosis.

DIAGNOSIS: Serology demonstrated a hypokalaemic, hypochloraemic metabolic alkalosis. Abdominal ultrasonography and barium studies confirmed the diagnosis of gastric outlet obstruction.

TREATMENT: Oesophago-gastro-duodenoscopy identified a hypertrophied closed pylorus with evidence of pyloric muscular hypertrophy. A laparoscopic pyloroplasty was performed.

DISCUSSION: Hypertrophic pyloric stenosis is the most common cause of gastric outlet obstruction in children. It typically occurs between 2 and 12 weeks of age and is very rarely found in older children. Primary acquired gastric outlet obstruction in late infancy and childhood is a rare cause of gastric outlet obstruction. Few cases have been reported in the literature outside of northern India. We present this case to highlight the need to consider this diagnosis in the older child.