Isolated pylorospasm in an infant: A diagnostic and therapeutic conundrum

Abstract

Persistent vomiting in a small infant can be due to delayed gastric emptying which is a significant cause of distress and morbidity. After ruling out common medical causes, evaluation for a surgical cause such as pyloric stenosis is imperative. The diagnosis of pylorospasm is often missed between the medical and surgical realms. We describe a six-week-old infant with persistent nonbilious vomiting who was referred with a suspicion of pyloric stenosis. However, on evaluation clinical findings and imaging were not suggestive of pyloric stenosis. A diagnosis of pylorospasm was made and the patient was managed with anticholinergics without any surgery. The patient had an unremarkable recovery. The diagnosis of pylorospasm needs to be kept in mind in an infant with persistent nonbilious vomiting. It responds satisfactorily with pharmacotherapy and avoids the need for surgery.

Keywords

• pylorospasm
• pyloric stenosis
• anticholinergic
• infant
• nonbilious vomiting