Case Report

An Analysis of Pediatric Scar Progression Over Time

Blaire Slavin Roberta Torres, MSN, RN, PNP-BC; Anne C. Fischer, MD, PhD, MBA

Disclosures

ePlasty. 2018;18(e18) 

In This Article

Case Report

Our patient was a male infant born at 36 weeks who by 4 weeks of age displayed a 5-day history of nonbilious, nonbloody emesis either directly after his feeds or several hours later. A laparoscopic pyloromyotomy was attempted, which was converted into a supraumbilical open pyloromyotomy due to inability to tolerate sufficient insufflation. The size of the surgical incision for the laparoscopic approach was 8 mm to accommodate a 5 mm umbilical port, followed by a 3 cm incision for the supraumbilical conversion.

The patient's family history was significant for pyloric stenosis across 3 generations since the newborn, his maternal grandmother, and his 2 maternal twin aunts all had IHPS. The grandmother had an oblique RUQ pyloromyotomy at 4 weeks of age in 1959 with an original scar incision of ~4 cm. Since her procedure 58 years ago, the grandmother's scar has grown 8 cm in length, with a current scar length of 12 cm. Aunt 1 underwent a transverse RUQ pyloromyotomy at 4 weeks of age in 1994, with an original incision length of 4 cm and a current scar length of 8 cm. Aunt 2 required a transverse RUQ pyloromyotomy at 6 weeks of age with an incision of 4 cm and a current scar length of 4 cm. Both aunts had the same surgeon and the same diagnosis within 2 weeks of each other. Aunt 2's scar size of 4 cm was smaller than her twin sister's 8 cm scar due to her short stature from Cornelia de Lange syndrome (Table 1).

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