Non-peptic, non-
hypertrophic pyloric stenosis has rarely been reported in pediatric literature. Endoscopic pyloric balloon dilation has been shown to be a safe procedure in treating
gastric outlet obstruction in older children and adults. Partial
gastric outlet obstruction (GOO) was diagnosed in an infant by history and confirmed by an upper gastrointestinal series (UGI). Abdominal ultrasonography and computed tomography scan excluded
idiopathic hypertrophic pyloric stenosis, abdominal
tumors, gastrointestinal and hepato-biliary-pancreatic anomalies. Endoscopic findings showed a pinhole-sized pylorus and did not indicate
peptic ulcer disease, Helicobacter pylori
infection,
antral web, or evidence of allergic and
inflammatory bowel diseases. Three sessions of a step-wise endoscopic pyloric balloon dilation were conducted under
general anesthesia and a fluoroscopy at two week intervals using
catheter balloons (Boston Scientific Microvasive(®), MA, USA) of increasing diameters. Repeat UGI after the first session revealed normal gastrointestinal transit and no
intestinal obstruction. The patient tolerated solid food without any gastrointestinal symptoms since the first session. The
endoscope was able to be passed through the pylorus after the last session. Although the etiology of GOO in this infant is unclear (proposed mechanisms are herein discussed), endoscopic pyloric balloon dilation was a safe procedure for treating this young infant with non-peptic, non-
hypertrophic pyloric stenosis and should be considered as an initial approach before pyloroplasty in such presentations.