Case 179

Full-term male infant, 21 days old, appropriate for gestational age (AGA), previously healthy, exclusively breastfed. Six days ago, he began vomiting in jet, with lacteal content vomitus, just after feedings, which progressed in intensity and frequency, resulting in weight loss. Clinical examination revealed adequate suction, signs of moderate dehydration and distended abdomen in upper quadrants. Abdominal ultrasound was inconclusive, and radiographies were requested (see attachments).

Based on the clinical and radiological findings, which is the most likely diagnosis?

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