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October 1966

Hypertrophic Pyloric StenosisAtypical Case Complicated by Massive Hemorrhage

Author Affiliations

From the departments of surgery (Dr. Swan) and pediatrics (Dr. Lussky), Northwestern University Medical School, Chicago, and Evanston Hospital, Evanston.

Arch Surg. 1966;93(4):677-679. doi:10.1001/archsurg.1966.01330040141029

THE PURPOSE of this paper is to report a case of hypertrophic pyloric stenosis in which, because diagnosis could not be confirmed by the usual preoperative means, surgical intervention was withheld until repeated life-threatening hemorrhage made it imperative. The immediate relief and continued freedom from symptoms that followed pyloromyotomy seem the best possible evidence that the preoperative symptoms, though atypical, were in fact manifestations of hypertrophy of the pylorus, which at laparotomy was found not only to match the classic descriptions but to be the only abnormality discernible.

Report of Case  The patient, born May 5, 1960, was a normal fullterm male infant with a birth weight of 3.6 kg (7 lb 14½ oz). He had a 3-year-old sister. He did well until 2 months of age when for three successive days in mid-July he vomited his evening feeding in projectile fashion. He did well for the next three weeks,

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