Adult idiopathic hypertrophic pyloric stenosis

J Formos Med Assoc. 2015 Jul;114(7):659-62. doi: 10.1016/j.jfma.2012.07.001. Epub 2012 Aug 10.

Abstract

Idiopathic hypertrophic pyloric stenosis (IHPS) is a predominantly infantile disease. The adult type of IHPS is extremely rare but it has been well recognized since the 19(th) century. We report a case of a 47-year-old male patient who presented with postprandial nausea and vomiting. He underwent upper gastrointestinal endoscopy, and gastric outlet obstruction was discovered. The upper gastrointestinal barium study showed a distended stomach with delayed gastric emptying due to pyloric stenosis. The abdominal computed tomography revealed thickening of the distal stomach. Since gastric malignancy could not be excluded, he underwent antrectomy with Billroth I anastomosis. The pathology revealed no malignancy but showed hypertrophy and hyperplasia of the inner circular muscle of the pylorus, which was compatible with IHPS. We reported the case to remind young physicians of this rare disease.

Keywords: adult; circular muscle; gastric outlet obstruction; idiopathic hypertrophic pyloric stenosis.

Publication types

  • Case Reports

MeSH terms

  • Endoscopy, Gastrointestinal
  • Gastrectomy
  • Humans
  • Hyperplasia / pathology
  • Hypertrophy / pathology
  • Male
  • Middle Aged
  • Nausea / etiology
  • Pyloric Stenosis, Hypertrophic / diagnosis*
  • Pyloric Stenosis, Hypertrophic / surgery*
  • Pylorus / pathology*
  • Tomography, X-Ray Computed
  • Vomiting / etiology