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May 1966

Pyloric Stenosis: A Case in Which a Second Gastrointestinal Lesion Was Masked by a Gastrostomy

Author Affiliations

From the departments of pediatrics and surgery, UCLA Center for the Health Sciences, Los Angeles (Drs. Nebert, Goldberg, and Gall), and the Medical Corps, Fort MacArthur (Dr. Burckin).

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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