Hypertrophic Pyloric Stenosis vs. Incarcerated Inguinal Hernia
Left picture: Due to the local findings, which exceed the already described somewhat prominent left upper belly (due to a gastric dilatation and an ineffective gastric tube), and include a gastric peristalsis wave running from the left upper belly to the right mid-abdomen, and a palpable pyloric tumor, the diagnosis is a hypertrophic pyloric stenosis. Right picture: In this patient which looked similarly discontented, the general examination yielded a painful and inflammatory swelling of the right groin and scrotum, corresponding to an incarcerated inguinoscrotal hernia with obstructive ileus as the cause of the recurrent vomiting. In vomiting during infancy, not only the classic pathologies of the upper gastrointestinal tract must be considered, but also causes of the residual intestine, such as obstructive ileus due to an incarcerated inguinal hernia as in the case report, and other causes of a surgical abdomen, as well as extraabdominal causes, such as febrile urinary tract infection in infancy.
Left picture: Young male infant with recurrent vomiting and a somewhat prominent upper left belly. Right picture: Local findings in a young male infant with recurrent vomiting.