Infantile Hypertrophic Pyloric Stenosis Following Repair of H-type Tracheoesophageal Fistula Repair and Post-operative Erythromycin Therapy

Natasha Merali,Allison R Wilcox,Daniel P Croitoru,Reto M Baertschiger

doi:10.47338/jns.v8.341

Natasha Merali, Allison R Wilcox + Show 2 more

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https://doi.org/10.47338/jns.v8.341

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Abstract

We present a rare case of a newborn with H-type tracheoesophageal fistula (TEF) who developed pyloric stenosis postoperatively, 10 days after he was started on erythromycin to promote gastric emptying. We report this case to describe the relationship between H-type TEF repair, erythromycin therapy, and the development of infantile hypertrophic pyloric stenosis.

Highlights

We present a rare case of a newborn with H-type tracheoesophageal fistula (TEF) who developed pyloric stenosis postoperatively, 10 days after he was started on erythromycin to promote gastric emptying
The prevalence of Esophageal atresia (EA)/TEF has remained stable over time, at approximately 2.5/10,000 births [1]
While EA/TEF is commonly associated with other malformations over 50% of the time, the incidence of infantile hypertrophic pyloric stenosis (IHPS) in patients with EA/TEF is not well established

Summary

Introduction

We present a rare case of a newborn with H-type tracheoesophageal fistula (TEF) who developed pyloric stenosis postoperatively, 10 days after he was started on erythromycin to promote gastric emptying. A barium swallow was obtained on the 2nd day of life, demonstrating severe esophageal stenosis with near atresia, a large proximal pouch, and an associated tracheoesophageal fistula (TEF) at the level of the atresia. The patient was fed through a Replogle tube until undergoing operative repair at 10 days of age.

Results

Conclusion