Late-onset primary gastric outlet obstruction--an unusual cause of growth retardation

We describe our experience of 2 children and review 6 previously reported cases of late-onset primary gastric outlet obstruction. The patients presented with abdominal pain, recurrent nonbilious vomiting, and growth retardation after a variable period of normal food intake. There was no history of peptic ulceration and corrosive ingestion. Barium meal showed dilated stomach with delayed gastric emptying. Exploration demonstrated dilated stomach with no intrinsic or extrinsic mechanical obstruction at the pylorus. Heineke-Mikulicz pyloroplasty was curative. Patients improved postoperatively and started thriving. We propose etiology and the term pyloric achalasia for this late-onset functional gastric outlet obstruction.