[Adhesive small bowel obstruction after surgery during infancy; a potentially fatal long term complication].

BACKGROUND:Pyloromyotomy, the treatment for infants with hypertrophic pyloric stenosis, is a procedure with a low risk of complications and quick recovery. We describe a rare and fatal complication. CASE DESCRIPTION:A 12-year old boy presents with persistent abdominal pain and vomiting at his general practitioner. After he collapses, cardiopulmonary resuscitation is started and he is brought to the hospital where he died. His medical history mentioned pyloromyotomy, complicated by fascia dehiscence and recurrent abdominal pain since the age of six. No cause was ever found for his abdominal pain. Autopsy was performed and showed feces in the abdominal cavity caused by two perforations and an adhesive small bowel obstruction (ASBO) from the jejunum to the abdominal wall localized at the scar tissue of the pyloromyotomy with internal herniation. CONCLUSION:Complaints of abdominal pain in children with previous abdominal surgery may be caused by adhesions. If abdominal pain persists and no other cause can be found, diagnostic laparoscopy should be considered.