Abstract
Infantile hypertrophic pyloric stenosis (IHPS) is a disorder encountered in infancy that is caused by hypertrophy of the musculature of the pylorus of the stomach. It may present as partial or complete gastric outlet obstruction. Multiple previous literatures have discussed the incidences and variability in the presentation of IHPS. However, there are very few reports of IHPS occurring in dizygotic twins, especially dizygotic twins of different sexes. Here we present a very rare case of dizygotic twins (a male and a female) affected with IHPS. With this study, we aim to identify the factors that lead to variability in severity and onset of symptoms in dizygotic twins of the opposite sex. We also aim to pay special attention to the etiology and mechanism of development of IHPS in dizygotic twins of the opposite sex.
Highlights
The incidence of hypertrophic pyloric stenosis among infants in the US is one to three per 1000 infants
We report a rare case of dizygotic twins of the opposite sex who were exclusively formula-fed presenting with infantile hypertrophic pyloric stenosis (IHPS) at different periods of life
Though genetic factors may contribute to the occurrence of IHPS, environmental factors demonstrate a strong association for the condition to occur
Summary
The incidence of hypertrophic pyloric stenosis among infants in the US is one to three per 1000 infants. It is more commonly identified in whites of European ancestry, is less common among black infants and is rarely seen in Asian infants. A large population registry data from Denmark evaluated for the familial association in pyloric stenosis and identified a 200fold increase in risk among monozygotic twins and only a 20-fold increase in risk among dizygotic twins compared to the general population without known affected relatives [2]. We report a rare case of dizygotic twins of the opposite sex who were exclusively formula-fed presenting with infantile hypertrophic pyloric stenosis (IHPS) at different periods of life. We reviewed the literature focusing on whether environmental factors play a role in variability of the duration of symptom appearance
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