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May 1966

Pyloric StenosisA Case in Which a Second Gastrointestinal Lesion Was Masked by a Gastrostomy

Am J Dis Child. 1966;111(5):544. doi:10.1001/archpedi.1966.02090080122012

CONCURRENCE of diseases may present diagnostic difficulties not inherent in the individual conditions. The patient described presented an example of an operated case of tracheo-esophageal fistula and gastrostomy which masked the usual signs of hypertrophic pyloric stenosis.

Report of a Case  The patient was the first boy born of a para 3, gravida 3, 37-year-old mother. Delivery followed an uncomplicated gestation and the birth weight was 6 lb 12 oz (3,062 gm). The first glucose-water feeding was regurgitated and a blind-end esophageal pouch and a tracheo-esophageal fistula were demonstrated radiographically. At operation the fistula was excised, and the proximal and distal esophageal segments were easily anastomosed. The postoperative course was relatively uncomplicated and a barium swallow roentgenogram before discharge demonstrated a normal esophagus. The week following discharge the infant was readmitted after he had regurgitated all feedings in the prior 12 hours. A barium swallow roentgenogram demonstrated a tight esophageal

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