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Pyloric Stenosis

Jennifer M. Cornwell, DO Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Progressive narrowing of the pyloric canal, occurring in infancy

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

EPIDEMIOLOGY

  • Onset almost always between 2 and 12 weeks of ag...

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

MEDICATION

First Line

  • Medical treatment with oral or IV atropine is an alternative to surgical treatment for IHPS (3).

  • Oral atropine: no reported adverse effects; initial dose of 0.05 mg/kg/day...

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.
2
Said M, Shaul D, Fujimoto M, et al. Ultra...

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.

  • Everett KV, Capon F, Georgoula C, et al. ...

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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