Details Descriptions About :: Pyloric Stenosis

 Pyloric stenosis is a narrowing of the pylorus—the outlet from the stomach to the small intestine. The incidence of pyloric stenosis is approximately 2 to 3 of every 1,000 infants. Age Alert Pyloric stenosis primarily occurs in infants. It occurs more commonly in boys than in girls and is rare in patients older than age 6 months.

Causes for Pyloric Stenosis

Causes Unknown, possibly related to genetic factors

Pathophysiology Pyloric Stenosis

Pathophysiology Pyloric stenosis is caused by hypertrophy and hyperplasia of the circular and longitudinal muscles of the pylorus. When the sphincter muscles thicken, they become inelastic and this leads to a narrowing of the opening. The pyloric canal becomes lengthened and the whole pylorus becomes thickened. The mucosa usually is edematous and thickened. The extra peristaltic effort needed to empty stomach contents into the small intestine leads to hypertrophied muscle layers of the stomach.

Signs and symptoms Pyloric Stenosis

Signs and symptoms Vomiting, mild initially and then becoming projectile In infants: appearing hungry most of the time Diarrhea Dehydration (poor skin turgor, depressed fontanels, dry mucous membranes, decreased tearing) Failure to gain weight or weight loss Dyspepsia Abdominal pain Abdominal distension Visible gastric peristalsis Firm, nontender, and mobile 1 to 2 cm hard mass, known as an olive, present in the midepigastrium to the right of midline; best palpated after the infant has vomited and when calm Diminished stools Lethargy

Diagnostic Lab Test results

Diagnostic test results Barium X-ray reveals a distended stomach and narrowed and elongated pylorus. Ultrasound shows thickened muscles of the pylorus. Chemistry panel often reveals hypochloremia, hypokalemia, and metabolic alkalosis. Hypernatremia or hyponatremia may also be present.

Treatment for Pyloric Stenosis

Treatment I.V. fluids Correction of electrolyte abnormalities Surgery Nothing by mouth before surgery; small frequent feedings after surgery

 

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