Retrograde Pylorogastric Intussusception-Case Report and Literature Review

A 6-month-old male presented with an acute onset of emesis and feeding intolerance. Abdominal ultrasound revealed a mass in the distal stomach immediately adjacent to the balloon of a gastrostomy button. Upper gastrointestinal (GI) series demonstrated persistence of the mass obstructing the pylorus even after deflation of the gastrostomy balloon with failure of contrast to empty from the stomach. Upper endoscopy revealed retrograde pylorogastric intussusception. The child then underwent laparotomy, and after removal of the gastrostomy, a Heineke-Mikulicz pyloroplasty was performed. Postoperative total parenteral nutrition was administered for 10 days at which point he was passing flatus and enteral oral feeding started. The postoperative course remained uncomplicated.

Type II Congenital Pyloric Atresia with Desquamative Enteropathy Diagnosed Postoperatively: A Case Report

Congenital pyloric atresia (CPA) is a rare condition that presents as gastric outlet obstruction in the first few weeks of life. Isolated CPA typically carries a good prognosis but when associated with other conditions such as multiple intestinal atresia or epidermolysis bullosa (EB), the outcomes are generally poor. This report describes a four-day-old infant who presented with nonbilious emesis and weight loss in whom an upper gastrointestinal contrast study revealed gastric outlet obstruction determined to be consistent with pyloric atresia. The patient underwent operative repair via Heineke-Mikulicz pyloroplasty. Postoperatively, the patient continued to have severe diarrhea and was found to have desquamative enteropathy though had no skin findings consistent with EB. This report emphasizes consideration of CPA as a differential diagnosis for neonates presenting with nonbilious emesis and demonstrates the association between CPA and desquamative enteropathy without EB.

A case of myopericarditis following administration of the Pfizer COVID-19 vaccine

Numerous vaccines have been developed to address the COVID-19 pandemic, the most frequently administered are the Moderna and Pfizer-BioNTech (Pfizer) mRNA COVID-19 vaccines. Of 177 million individuals that have full vaccination status, there have been 1,148 cases of myocarditis or pericarditis reported. At this time, the relationship between myopericarditis and the Pfizer mRNA COVID-19 vaccine has not been well established in current literature due to the novelty of the vaccine. We discuss a 16-year-old male who presented to the emergency department with chest pain 48 hours after receiving his second dose of the Pfizer COVID-19 vaccine. His laboratory and electrocardiogram findings were consistent with acute myopericarditis and work-up did not reveal an obvious etiology. After starting anti-inflammatory therapies, the patient’s symptoms and laboratory markers improved and the patient was discharged from the hospital expected to make a full recovery. This case demonstrates the rapid recovery with no sequelae following this adverse effect, highlighting that the benefits of the COVID-19 vaccination most likely outweigh the risks.