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Pyloric Stenosis

Blake Leeds, D.O. and Laura B Bishop, M.D. Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Acquired narrowing of the pyloric canal due to progressive hypertrophy of pyloric muscle leading to obstruction, usually occurs in the first 2-12 weeks of life

  • Synonym(s): infantile h...

DIAGNOSIS

HISTORY

  • Nonbilious projectile vomiting after feeding, increasing in frequency and severity

  • Emesis may become blood-tinged from gastric irritation.

  • Hunger due to inadequate nutrition

  • Excessive cr...

TREATMENT

GENERAL MEASURES

  • Treat dehydration and alkalosis before surgery.

  • Preoperative antibiotics (cefazolin 30 mg/kg or clindamycin 10 mg/kg IV) for infection prophylaxis

  • Usually no need for preoperat...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Discharge following surgery when tolerating 2-3 full feeds (1)[C]. 

Patient Monitoring

  • Routine pediatric health maintenance

  • Postoperative monitoring, including moni...

REFERENCES

1
Peters  B, Oomen  MW, Bakx  R, et al. Advances in infantile hypertrophic pyloric stenosis. Expert Rev Gastroenterol Hepatol.  2014; 8(5): 533– 541.  [View Abst...

ADDITIONAL READING

  • Ein  SH, Masiakos PT, Ein  A. The ins and outs of pyloromyotomy: what we have learned in 35 years. Pediatr Surg Int.  2014; 30(5): 467– 480.  [View A...

CODES

ICD10

Q40.0 Congenital hypertrophic pyloric stenosis 

SNOMED

  • 48644003 Congenital hypertrophic pyloric stenosis

  • 204671009 Congenital pyloric stenosis

CLINICAL PEARLS

  • Pyloric stenosis is the most common condition requiring surgical intervention in the 1st year of life.

  • The condition classically presents between 1 and 5 months of life, with projectile...

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