Hypertrophic pyloric stenosis and pulmonary hypertension in a neonate. A common mechanism?
Nitric oxide (NO) is an important mediator of biological functions. Absence or shortage of NO plays a role in the pathogenesis of both hypertrophic pyloric stenosis and persistent pulmonary hypertension. We present a neonate diagnosed with pulmonary hypertension after birth caused by meconium-aspiration syndrome eventually treated with extracorporal membrane oxygenation followed by hypertrophic pyloric stenosis for which a pyloromyotomy was performed. In conclusion, the association of pulmonary hypertension and pyloric stenosis has not been described before and may be explained by a lowered plasma concentration of arginine leading to deficient NO synthesis in the affected organ systems.
Brouwers
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AG
Department of Paediatric Intensive Care, Academic Hospital Maastricht, P. Debyelaan 25, Maastricht, The Netherlands. A.Brouwers@mumc.nl
Waals-van de Wal
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CM
D005112:Extracorporeal Circulation; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D007231:Infant, Newborn; D008297:Male; D008471:Meconium Aspiration Syndrome / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D046248:Pyloric Stenosis, Hypertrophic / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D011708:Pylorus / Q000601:surgery; D012121:Respiration, Artificial