A rare case of congenital pyloric atresia with situs inversus abdominalis

Abstract

Congenital pyloric atresia and situs inversus are rare conditions. The combination of congenital pyloric atresia and situs inversus is extremely rare, only two such cases reported in the literature so far. We present third such case of a term, male baby born to a primigravida mother. All antenatal ultrasound up to 31 weeks were unremarkable. Follow-up antenatal ultrasound was suggestive of duodenal atresia. The baby was noted to have respiratory distress at birth requiring respiratory support in the form of nasal continuous positive air pressure. X-ray abdomen revealed a single bubble sign, but toward the right side of the abdomen, cardiac shadow being on the left side, suggestive of congenital pyloric atresia along with situs inversus abdominalis. The baby was operated, laparotomy done, findings confirmed, and retrograde side-to-side gastroduodenostomy was done. Postoperatively, feeds were started and baby discharged on day 17 of life. Isolated congenital pyloric atresia has a good prognosis and all attempts should be made to identify other possible associations (since there are different anomalies associated with congenital pyloric atresia such as junctional epidermolysis bullosa, renal anomalies [hydroureteronephrosis, multicystic kidney, absent bladder], aplasia cutis congenita, and colonic atresia).