Abstract
Prostaglandin E1 (PGE1) is widely used in ductus-dependant congenital heart disease to maintain the patency of ductus. Hypertrophic pyloric stenosis (HPS) due to gastric mucosal proliferation is a rare complication of prolonged PGE infusion. A male newborn who developed HPS during PGE1 infusion is presented to discuss the clinical features and treatment modalities of PGE-related transient HPS. The boy was 2500 g and born at 35 weeks of gestation from a 23-year-old mother. He was admitted to neonatal intensive care with breathing difficulty and cyanosis. His echocardiography revealed pulmonary atresia, ventricular septal defect and major aorta-pulmonary collateral (MAPCA). PGE infusion with a dose of 0.05 mcg kg–1 was initiated. At the 8th day of infusion, he developed non-billous vomiting. Ultrasonographic evaluation revealed 1.9 cm length of pyloric channel and 0.5 cm of wall thickness on 11th day and diagnosed as HPS. On 42th postnatal day, he underwent MAPCA closure, right modified Blalock-Taussi shunt and repair of pulmonary artery bifurcation with bovine patch. PGE infusion was stopped and enteral nutrition was started on 8th postoperative day. Control ultrasonography on 12th postoperative day revealed normal pyloric channel length (0.9 cm) and wall thickness (0.3 cm). Prolonged use of PGE infusion in neonates with congenital heart disease may cause transient HPS. The clinical and radiological features of HPS relieves after stopping PGE infusion. It should be kept in mind that HPS due to PGE infusion can be transient and pyloromyotomy should be kept for patients with persistent findings.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Kosiak W, Sweiton D, Fryze I, Aleszewicz-Baranowska J, Duklas M, Chojnicki M . Gastric outlet obstruction due to an iatrogenic cause in a neonatal period- Report of two cases. Ultraschall Med 2008; 29: 401–403.
Lewis AB, Freed MD, Heymann MA, Roehl SL, Kensey RC . Side effects of therapy with prostaglandin E1 in infants with critical congenital heart disease. Circulation 1981; 64: 893–898.
Peled N, Dagan O, Bayn P, Silver MM, Barker G, Hellmann J et al. Gastric-outlet obstruction induced by prostaglandin therapy in neonates. N Engl J Med 1992; 327: 505–510.
Shinohara K, Shimizu T, Igarashi J, Yamashiro Y, Miyano T . Correlation of prostaglandin E2 production and gastric acid secretion in infants with hypertrophic pyloric stenosis. J Pediatr Surg 1998; 33: 1483–1485.
Callahan MJ, McCauley RG, Patel H, Hijazi ZM . The development of hypertrophic pyloric stenosis in a patient with prostaglandin-induced foveolar hyperplasia. Pediatr Radiol 1999; 29: 748–751.
Lacher M, Schneider K, Dalla Pozza R, Schweinitz D . Gastric outlet obstruction after long-term prostaglandin administration mimicking hypertrophic pyloric stenosis. Eur J Pediatr Surg 2007; 17: 362–364.
Perme T, Mali S, Vidmar I, Gvardijančič D, Blumauer R, Mishaly D et al. Prolonged prostaglandin E1 therapy in a neonate with pulmonary atresia and ventricular septal defect and the development of antral foveolar hyperplasia and hypertrophic pyloric stenosis. Ups J Med Sci 2013; 118: 138–142.
Forman HP, Leonidas JC, Kronfeld GD . A rational approach to the diagnosis of hypertrophic pyloric stenosis: do the results match the claims? J Pediatr Surg 1990; 25: 262–266.
Kriss VM, Desai NS . Relation of gastric distention to prostaglandin therapy in neonates. Radiology 1993; 203: 219–221.
Mercado-Deane MG, Burton EM, Brawley AV, Hatley R . Prostaglandin induced foveolar hyperplasia simulating pyloric stenosis in an infant with cyanotic heart disease. Pediatr Radiol 1994; 24: 45–46.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Soyer, T., Yalcin, S., Bozkaya, D. et al. Transient hypertrophic pyloric stenosis due to prostoglandin infusion. J Perinatol 34, 800–801 (2014). https://doi.org/10.1038/jp.2014.101
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/jp.2014.101
This article is cited by
-
Effect of prostaglandin-E1 treatment on pyloric wall thickness in newborns with ductal-dependent critical congenital heart diseases
Pediatric Surgery International (2023)
-
Alprostadil
Reactions Weekly (2015)