新生儿食管闭锁修复术后肥厚型幽门狭窄1例

Hypertrophic pyloric stenosis following neonatal esophageal atresia repair:a case report

本文报道了1例发生在新生儿食管闭锁修复术后的肥厚型幽门狭窄的患儿。患儿母亲产前未规律产前检查。患儿出生胎龄40周+2,出生时羊水量多,生后即诊断食管闭锁,腭裂,行胸腔镜下食管气管瘘结扎术+食管端端吻合术,术后予鼻饲喂养。4月龄时鼻饲奶后出现呕吐较多咖啡样物,超声及造影提示肥厚型幽门狭窄,行幽门环肌切开术治疗,效果良好。由本例认为,食管闭锁术后的患儿如发生不明原因的非胆汁性呕吐/喂养困难,需考虑肥厚性幽门狭窄的可能。明确诊断后,可行腹腔镜下治疗。

This article reported a case of hypertrophic pyloric stenosis after neonatal esophageal atresia repair.The mother of the child did not have regular prenatal care.The child was born at a gestational age of 40 weeks and 2 days of gestation,with polyhydramnios at birth,and was diagnosed with esophageal atresia and cleft palate after birth and underwent thoracoscopic esophageal-esophageal end-to-end anastomosis and esophageal-tracheal fistula ligation and was given nasogastric feeding after surgery.At four months of age,the child vomited a lot of coffee-like material after nasogastric feeding,and the ultrasonographic and upper gastroenterography findings suggested hypertrophic pyloric stenosis,which was treated surgically with good results.This case suggests that hypertrophic pyloric stenosis should be considered in children with unexplained non-bilious vomiting/feeding difficulties after esophageal atresia repair.After definitive diagnosis,laparoscopic pyloromyotomy is feasible.