Hypertrophic Stenosis of the Neonatal Pylorus: Laparoscopic Treatment

Hypertrophic pyloric stenosis (HPS) can be diagnosed in the neonatal period. The aim of this work is to identify the clinical and paraclinical features that allow the diagnosis of HPS in the neonatal period, and to detail the laparoscopic surgical technique.The case involved a 20-day-old male neonate born at 41 days' gestation, PN 3870g, presenting with white regurgitation and vomiting, losing 650g in 6 days. Clinical examination revealed clinical and biological dehydration. Abdominal ultrasound confirmed the diagnosis of HPS, with a pylorus 21mm long and 5mm thick. Hydroelectrolyte rehydration was started. Laparoscopic pylorotomy was performed within 36 hours of hospitalization. Early and progressive postoperative refeeding was introduced with good immediate and long-term outcome. Laparoscopic treatment of HPS is safe, reliable and effective even at neonatal age, but it is not without risks and requires a long learning curve.