Pyloric stenosis

Question 1

What is pyloric stenosis?

Answer 1

Hypertrophy of pylorus muscle leading to gastric outlet obstruction.

Question 2

What are the ‘‘FIRSTS’‘of Pyloric Stenosis?

Answer 2

-More often occurs in 1st borns
-Around 1st month of life
-Emesis is 1st thing after feeding
-1st thing a doctor must do is correct the electrolytes.

*Also related to male gender and use of macrolides in the first 2 weeks
of life.

Question 3

Clinical picture of Pyloric stenosis

Answer 3

Vomiting is non-bilious, projectile, and post-prandial.
Baby is starving and wants to keep eating immediately after vomiting.

Question 4

Diagnosis of Pyloric Stenosis

Answer 4

Palpable “olive-like” mass in RUQ
Dehydration
Jaundice.
**US confirms diagnosis
Labs show hypochloremic, hypokalemic metabolic alkalosis.

Question 5

Treatment of Pyloric stenosis

Answer 5

■ Before surgery, correct fluid loss/electrolytes with 0.9% normal saline
■ Surgery: pyloromyotomy (laparoscopically). Feed after 12-24 hours.