The diagnosis and treatment of pyloric stenosis in infants has been well established for many years.1 The incidence of pyloric stenosis in premature infants is unusual,1 the presentation is atypical,2-5 and the diagnosis delayed, if not difficult.2-5 Recently, four premature infants with pyloric stenosis demonstrated these features and underscored the limitations of ultrasonographic imaging in premature infants.5,6
Patient Reports.Patient 1. A premature male infant (weighing 2100 g at 35 weeks' gestation) with the onset of nonprojectile vomiting at 6 weeks of age was evaluated by ultrasound at 7 weeks of age. Ultrasound findings were normal (pyloric muscle thickness, 2.4 mm), and vomiting persisted. An upper gastrointestinal contrast study performed at 8 weeks of age confirmed pyloric stenosis.
Patient 2. A premature male infant (weighing 1610 g at 31 weeks' gestation) with the onset of nonbilious nonprojectile vomiting at 5 weeks of age was evaluated