Pyloric Stenosis

Question 1

What is pyloric stenosis?

Answer 1

Hypertrophy and therefore narrowing of the pylorus

Prevents food traveling from the stomach to the duodenum

Question 2

How does pyloric stenosis cause vomiting?

Answer 2

After feeding, powerful peristalsis tries to push food into the duodenum

Becomes so powerful that it ejects the food into the oesophagus

Projectile vomiting

Question 3

When does pyloric stenosis present?

Answer 3

Typically presents in the first few weeks of life

Hungry baby - thin, pale and generally failing to thrive

Question 4

What can you see examing a baby with pyloric stenosis after feeding?

Answer 4

Peristalsis can be seen by observing the abdomen

firm, round mass can be felt in the upper abdomen that “feels like a large olive” - Hypertrophic muscle of the pylorus

Question 5

What is seen on blood gas of pyloric stenosis?

Answer 5

Blood gas analysis will show a hypochloric metabolic alkalosis - due to vomiting

Question 6

What is the management of pyloric stenosis?

Answer 6

Diagnosis - Abdo USS

Laparoscopic pyloromyotomy (known as “Ramstedt’s operation“) - widens pylorus