Endoscopic balloon dilatation for insufficient laparoscopic pyloromyotomy in pyloric stenosis

Endoscopic balloon dilatation for insufficient Laparoscopic Pyloromyotomy in Pyloric Stenosis: A 2 month-old boy presented with projectile, non-bilious vomiting and failure to thrive. Clinical suspicion of pyloric stenosis was confirmed with ultrasound. After correction of the hypokalemic hypochloremic metabolic alkalosis a laparoscopic pyloromyotomy was performed. The baby continued to vomit with evident gastric peristalsis in the epigastrium. Upper GI contrast study on post-operative day 3 revealed residual proximal pyloric stenosis. An upper GI endoscopy was performed confirming residual stenosis which was ablated with balloon dilatation. This resulted in immediate improvement for the baby and tolerance of feeds. Discussion – endoscopic balloon dilatation for insufficient pyloromyotomy has not been reported previously. This proved a very useful and safe technique in this setting which occurs in 4% of laparoscopic pyloromyotomies.

Author(s): Niall Martin Jones

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