2018 Volume 54 Issue 2 Pages 264-267
We report herein two cases of hypertrophic pyloric stenosis (HPS) in patients presenting with prenatal polyhydramnios. Patient 1 suddenly showed polyhydramnios and dilated stomach with active peristalsis at 36 weeks of gestational age as determined by prenatal ultrasonography. A 3,210 g boy was delivered at 38 weeks of gestational age and immediately diagnosed as having HPS on the basis of findings of ultrasonography and upper gastrointestinal series. Patient 2 also showed polyhydramnios prenatally at 28 weeks of gestational age. A 2,398 g boy was delivered at 36 weeks by emergent Caesarean section. He had no symptoms after birth, but started vomiting from 15 days after birth. He was transferred to our hospital and diagnosed as having HPS. Both patients presented with polyhydramnios at different periods of pregnancy and showed different postnatal clinical courses. Patient 1 presented with a rapid worsening of hydramnios during the late pregnancy period and developed HPS soon after birth. In contrast, patient 2 presented with a gradual worsening of hydramnios from the second trimester of pregnancy and developed HPS three weeks after birth. The polyhydramnios in patient 1 was likely induced by the in utero onset of HPS. In cases of prenatal polyhydramnios, HPS should be suspected and diagnosed by carefully detecting stomach dilation and hyperperistalsis.
