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Pyloric Stenosis

Jennifer M. Cornwell, DO Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Progressive narrowing of the pyloric canal, occurring in infancy

  • Synonym(s): infantile hypertrophic pyloric stenosis (IHPS)

EPIDEMIOLOGY

  • Predominant age: infancy

    • Onset usually at 3 to ...

DIAGNOSIS

HISTORY

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

  • Emesis may become blood-tinged from vomiting-induced gastric irritation.

  • Hunger due to inadequate nutr...

TREATMENT

SURGERY/OTHER PROCEDURES

  • Ramstedt pyloromyotomy is curative. The entire length of hypertrophied muscle is divided, with preservation of the underlying mucosa.

  • Surgical approaches include open ...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • Routine pediatric health maintenance

  • Postoperative monitoring, including monitoring for pain, emesis, apnea

  • If significant emesis present after 1 ...

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 Abstract on OvidMedline]
2
Bakker MK...

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 Abstract on OvidMedline]

  • Everett K...

CODES

ICD10

Q40.0 Congenital hypertrophic pyloric stenosis 

ICD9

750.5 Congenital hypertrophic pyloric stenosis 

SNOMED

  • 48644003 Congenital hypertrophic pyloric stenosis

  • 204671009 Congenital pyloric stenosi...

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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