Pyloric Stenosis Flashcards
What is the definition of pyloric stenosis?
Hypertrophy of the pyloric muscle –> gastric outlet obstruction
In what age do pyloric stenosis patients present?
@ 2-7 weeks of age
What is the ratio of pyloric stenosis in boys:girls?
4:1
What is the main risk factor for pyloric stenosis?
Family history, esp. on the maternal side
What are the symptoms of pyloric stenosis?
Non-bilious vomiting
Hunger after vomiting –> dehydration –> decreased feeding
Weight loss (later)
Features of dehydration
What happens to the vomiting over time in pyloric stenosis?
Increasing frequency and forcefulness –> projectile
What are the signs of pyloric stenosis?
Gastric peristalsis (from left to right on abdomen) Palpable mass in RUQ (= pyloric mass)
What are the investigations for pyloric stenosis?
Bloods - hypochloraemic metabolic alkalosis and hypo-natraemia and -kalaemia
Abdominal ultrasound - >4mm pyloric muscle thickness and >17mm pyloric canal length
When is an abdominal ultrasound useful in pyloric stenosis?
If diagnosis is uncertain
What is the immediate management required for pyloric stenosis?
Fluid resuscitation - w/ 0.45% saline + 5% dextrose + K+ supplements
What is the definitive management for pyloric stenosis?
Pyloromyotomy = division of hypertrophied muscle down to but not including the mucosa
How is a pyloromyotomy done?
Can be open or laparoscopic
Pt is fed within 6 hours and discharged 2 days post-op
What is the approximate success rate of a pyloromyotomy for pyloric stenosis?
Nearly 100%
What are the complications of pyloric stenosis often associated with?
Due to surgery
What are the complications of pyloric stenosis?
Post-op emesis
Wound infection
Mucosal perforation
