Hypertrophic pyloric stenosis in a neonate: A case report

Hypertrophic pyloric stenosis (HPS) typically presents between the third and eighth weeks of life. Presentation in the immediate neonatal period is rare and clinically challenging. A male neonate was born at 39 weeks and 3 days of gestation via spontaneous vaginal delivery with a birth weight of 2720 g. The pregnancy and delivery were uneventful. On the second day of life, the newborn developed non-bilious, non-projectile vomiting and feeding intolerance. Physical examination was unremarkable, and laboratory studies, including serum electrolytes, were within normal limits. Abdominal ultrasonography demonstrated an elongated and thickened pyloric canal with a “cervical-sign” configuration, measuring 13.4 mm in length and 3.1 mm in wall thickness, consistent with hypertrophic pyloric stenosis. The neonate underwent open Ramstedt Pyloromyotomy. The postoperative course was uneventful. Hypertrophic pyloric stenosis can present in the first days of life and should be considered in early neonates who develop non-bilious vomiting or feeding intolerance.