Idiopathic hypertrophic pyloric stenosis in identical twins.

Idiopathic hypertrophic pyloric stenosis (IHPS) was thought to be a congenital disease traditionally, even though several published reports assumed IHPS was an acquired disease. The pathogenesis and inheritance patterns of IHPS are not fully understood. Except for the familial recurrence of IHPS, concordance of IHPS in monozygotic or dizygotic twins was also noted, but occurrence in female twins is rare. From July 1992 through June 2000, 130 patients were diagnosed with IHPS in our hospital including one pair of female twins. We present the finding in the twins and review the associated articles about the pathogenesis and inheritance patterns of IHPS.

Tension pneumoperitoneum following instrumental perforation of an obstructed esophagus in an infant.

A 4-month-old infant was diagnosed with esophageal atresia and tracheoesophageal fistula. He was admitted to our hospital because of progressive poor findings and repeated aspiration pneumonia after surgical repair. An esophagogram demonstrated severe esophageal stricture. Flexible endoscopic dilatation was performed under general anesthesia, but sudden onset respiratory distress and progressive abdominal distention were noted during the procedure. Abdominal radiographic study revealed severe pneumoperitoneum. Tension pneumoperitoneum after perforation of the obstructed esophagus is extremely rare but life threatening. We herein report our experience with the successful management of this complication in an infant.