Objectives: A 6-month-old male presented with 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. A single contrast fluoroscopic upper gastrointestinal (GI) series demonstrated persistence of the mass obstructing the pylorus even after deflation of the gastrostomy balloon and contrast did not empty from the stomach. Upper endoscopy confirmed retrograde pyloro-gastric intussusception. The child then underwent laparotomy and after closure of the gastrostomy, a Heineke-Mikulicz pyloroplasty was performed. Post-operative total parenteral nutrition was administered for 10 days at which point he was passing flatus and enteral oral feeding started. The post-operative course remained uncomplicated, and the patient was ultimately discharged two weeks after surgery. One month after discharge the child was taking all nutrition by mouth and consistently gaining weight.
