PYLORIC STENOSIS

(Hypertrophic Pyloric Stenosis)

 Basic information

description

Pyloric stenosis is a condition of infancy in which encircling muscles at the end of the stomach enlarge and cause obstruction. It affects the pylorus (a muscular tube that carries food from the stomach to the small intestine). It is more common in firstborn males and usually begins between 2 and 5 weeks of age, but can occur as late as 4 months.

FREQUENT SIGNS & SYMPTOMS

• Recurrent vomiting episodes that become more forceful (projectile vomiting). It usually occurs after feeding.
• Muscular, olive-sized mass in the upper abdomen (sometimes).
• No pain or fever. Infant seems happy, but hungry, after vomiting.
• Gradual weight loss and dehydration.

causes

The muscular band that encircles the pylorus thickens and eventually closes off the outlet from the stomach. Why this occurs is unknown.

risk increases with

Family history of pyloric stenosis.

PREVENTIVE MEASURES

Cannot be prevented at present.

expected outcomes

Curable with surgery. The child usually recovers quickly with no long-lasting effects.

possible complications

• Without treatment, it can cause dehydration, weight loss, stomach irritation, and possibly jaundice (yellow skin and eyes).
• Rarely, complications from surgery may occur such as bleeding or infection.

 diagnosis & treatment

general measures

• Your child's health care provider will do a physical exam. A barium-swallow x-ray or ultrasound may be done to confirm the diagnosis.
• Treatment is surgery to cut the thickened muscle (pyloromyotomy). In rare cases, treatment may involve a nonsurgical method.
• Fluids and electrolytes will be given through a vein (IV) until the baby is ready for surgery.
• Following surgery, you will be advised as to how to care for the incision and when you can give the baby a bath.

medications

Acetaminophen may be recommended after surgery if the baby appears to have pain or discomfort.

activity

No limits following surgery.

diet

• The baby will start being fed liquids about 4 to 6 hours after surgery. Feedings are gradually increased until a normal feeding schedule is resumed. This may take 1 to 2 days and then you can take the baby home.
• Your baby may still vomit a small amount for a day or two after surgery.

 notify our office if

• Your baby has symptoms of pyloric stenosis.
• The following occur after surgery:
  • Pain, swelling, redness, bleeding, or drainage at the surgical site.
  • Temperature rises to 101°F (38.3°C).
  • Vomiting is frequent or goes on for 2 or 3 days.

Special Notes: