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Pyloric Stenosis, Pediatric

Pradeep P. Nazarey, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

Hypertrophy of the muscular layers of the pylorus with elongation and thickening, leading to projectile nonbilious emesis and gastric outlet obstruction 

EPIDEMIOLOGY

  • Usually presents ...

DIAGNOSIS

HISTORY

  • Emesis

    • Otherwise healthy full-term infant that initially vomits intermittently

    • Over time (approximately 2 weeks), frequency slowly progresses to emesis with nearly every feeding.

    • Emesis ...

TREATMENT

ADMISSION, INPATIENT, AND NURSING CONSIDERATIONS

  • Early identification of electrolyte abnormalities and correction with appropriate IV fluids

  • Bolus with 10 to 20 mL/kg of normal saline (NS)

    • Foll...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Vomiting may persist for days after the operation.

  • Babies are seen 2 weeks after discharge in clinic.

ALERT
  • Alkalosis must be corrected prior to surgery to prevent d...

ADDITIONAL READING

  • Hernanz-Schulman M. Pyloric stenosis: role of imaging. Pediatr Radiol.  2009;39(Suppl 2):S134–S139. [View Abstract on OvidInsights]

  • Pandya S, Heiss K. Pyloric stenosis in pediat...

CODES

ICD9

750.5 Congenital hypertrophic pyloric stenosis 

ICD10

Q40.0 Congenital hypertrophic pyloric stenosis 

SNOMED

48644003 Congenital hypertrophic pyloric stenosis 

FAQ

  • Q: What is the best initial imaging study to help make the diagnosis?

  • A: An abdominal ultrasound is the best initial imaging study to obtain, as the pylorus can be well visualized.

  • Q: Why is so much...

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