| ID | 406 |
|---|---|
| Name | CONGENITAL HYPERTROPHIC PYLORIC STENOSIS |
| Cause | The causes of pyloric stenosis are unknown, but genetic and environmental factors might play a role. Pyloric stenosis usually isn't present at birth and probably develops afterward |
| Signs Symptoms | Vomiting after feeding. The baby may vomit forcefully, ejecting breast milk or formula up to several feet away. ... Persistent hunger. Babies who have pyloric stenosis often want to eat soon after vomiting. Stomach contractions. ... Dehydration. ... Changes in bowel movements. ... Weight problems. |
| Diagnosis | Diagnosis of hypertrophic pyloric stenosis is by abdominal ultrasonography showing increased thickness of the pylorus (typically to ≥ 4 mm; normal, < 3 mm) along with an elongated pylorus (> 16 mm). |
| Investigations | Abdominal ultrasound -- the gold standard for diagnosing pyloric stenosis. This is an imaging technique that uses high frequency sound waves and a computer to create images of blood vessels, tissues, and organs. It is used to find out the thickness and length of the pyloric muscle. |
| Management | Surgery is needed to treat pyloric stenosis. The procedure, called a pyloromyotomy, is often scheduled on the same day as the diagnosis. ... After surgery: Your baby might be given intravenous fluids for a few hours. ... Your baby might want to feed more often. Some vomiting may continue for a few days. |
| Introduction | It develops in most cases during the second or third week of life. The exact pathology Is unknown, but there is a clear genetic influence. A diffuse hypertrophy and hyperplasia of the smooth muscle of pyloric sphincter and sorrounding area occur usually |
| History | |
| Etiology | The causes of pyloric stenosis are unknown, but genetic and environmental factors might play a role. Pyloric stenosis usually isn't present at birth and probably develops afterward. |
| Clinical Features | Clinical features: 1. Regurgitation or non projectile vomiting initially. 2. The vomiting becomes projectile usually within 2-4 weeks of onset. 3. Vomiting may occur after each feeding. The vomitus is never bile stained but occasionally may contain altered blood. 4. Stool becomes very small and infrequent. 5. Physical examination shows varying degrees of dehydration and lethergy with or without “old man appearance.” 6. Visible peristalsis from left to right can be observed just after feeding. 7. Palpation in the right side of the epigastrium may reveal the thickened pyloric muscle as a small hard tumour. |
| Preventions | There's no way to prevent pyloric stenosis. If you know pyloric stenosis runs in your family, make sure to tell your healthcare provider. The provider can be on the lookout for any signs or symptoms of the condition. Knowing the signs and symptoms of pyloric stenosis means you can get help as soon as possible |
| Treatment | Treatment: Surgical relief of the pyloric obstruction (Fredet Ramstedt pyloromyotomy) as soon as the diagnosis is established and the metabolic imbalances should be corrected. |
| Complications | Pyloric stenosis can lead to: Failure to grow and develop. Dehydration. Frequent vomiting can cause dehydration and a mineral imbalance. ... Stomach irritation. Repeated vomiting can irritate your baby's stomach and may cause mild bleeding. Jaundice. |
| Prognosis | Recovery. In general, patients who receive surgical treatment for pyloric stenosis have an excellent recovery and very few suffer any long-term problems as a result of the disease. After surgery, your baby may be fed special fluids for one or two feedings and then breast milk or formula within 24 hours. |
| Types | There is no established system for the classification of pyloric stenosis. It may be subclassified as infantile pyloric stenosis and adult-onset hypertrophic pyloric stenosis |
| Classification | There is no established system for the classification of pyloric stenosis. It may be subclassified as infantile pyloric stenosis and adult-onset hypertrophic pyloric stenosis |
| Observation | The most common symptoms noted in a baby with pyloric stenosis is forceful, projectile vomiting. This kind of vomiting is different from a "wet burp" that a baby may have at the end of a feeding. Large amounts of breast milk or formula are vomited, and may go several feet across a room. |
| Pathology | Pyloric stenosis, also known as infantile hypertrophic pyloric stenosis (IHPS), is an uncommon condition in infants characterized by abnormal thickening of the pylorus muscles in the stomach leading to gastric outlet obstruction. Clinically infants are well at birth |
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