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PYLORIC STENOSIS SUMMARY: Causes- Symptoms- Signs- Diagnosis: Hypertrophic Pyloric Stenosis Lecture
How do I know if my baby has pyloric stenosis?
Signs include:
Vomiting after feeding. The baby may vomit forcefully, ejecting breast milk or formula up to several feet away (projectile vomiting)
Persistent hunger. Babies who have pyloric stenosis often want to eat soon after vomiting.
Stomach contractions
Dehydration
Is pyloric stenosis life-threatening?
Although this condition is ultimately treated surgically, it may present as a medical emergency due to electrolyte derangements.
Can a baby grow out of pyloric stenosis?
Long-term outlook. Pyloric stenosis is unlikely to reoccur. Babies who have undergone surgery for pyloric stenosis should have no long-term effects from it.
How is pyloric stenosis diagnosed?
Blood tests to check for dehydration or electrolyte imbalance or both. Ultrasound to view the pylorus and confirm a diagnosis of pyloric stenosis. X-rays of your baby's digestive system, if results of the ultrasound aren't clear
How often does a baby vomit with pyloric stenosis?
While occasional dribbles of spit-up after meals is common in infants and usually harmless, true vomiting is more concerning. In some babies, frequent projectile vomiting can be a symptom of a condition called hypertrophic pyloric stenosis (HPS); it occurs in 1 out of every 500 or so babies
What happens if pyloric stenosis goes untreated?
If left untreated, hypertrophic pyloric stenosis can cause: Dehydration. Electrolyte imbalance. Lethargy.
Is pyloric stenosis a birth defect?
Pyloric stenosis is a birth defect. This means that your child is born with it. This condition may run in some families. It's a multifactorial trait.
Can babies with pyloric stenosis still gain weight?
Babies with pyloric stenosis usually have fewer, smaller stools because little or no food is reaching the intestines. Constipation or stools that have mucus in them may also be symptoms. Failure to gain weight and lethargy. Most babies with pyloric stenosis will fail to gain weight or will lose weight.
Is pyloric stenosis an emergency?
Emergency Department Care
Infantile hypertrophic pyloric stenosis (IHPS) may be described as a medical emergency or a medical urgency based on how early in the course the patient presents.
Can pyloric stenosis cause problems later in life?
Some vomiting may be expected during the first days after surgery as the gastrointestinal tract settles. Rarely, the myotomy procedure performed is incomplete and projectile vomiting continues, requiring repeat surgery. Pyloric stenosis generally has no long term side-effects or impact on the child's future.
How quickly does pyloric stenosis progress?
Babies usually aren't born with pyloric stenosis. The thickening of the pylorus starts to happen in the weeks after birth. Pyloric stenosis symptoms usually start when the baby is 2 to 8 weeks old. But it can take up to five months for the symptoms to become apparent.
At what age is pyloric stenosis diagnosed?
The usual age of presentation is approximately 2 – 6 weeks of life. Approximately 95% of infantile hypertrophic pyloric stenosis cases are diagnosed in those aged 3-12 weeks.
Why is pyloric stenosis more common in males?
Infantile hypertrophic pyloric stenosis is 5 times more common in male infants. The male hormone testosterone is known to induce muscle hypertrophy, and testosterone levels are several-fold higher in male infants than female infants.
Can pyloric stenosis be treated without surgery?
Pyloric stenosis needs to be treated. It won't improve on its own. Your child will need surgery called pyloromyotomy.
Can pyloric stenosis be missed on ultrasound?
Ultrasonography, although reliable for diagnosing hypertrophic pyloric stenosis, may miss malrotation, which is the most serious cause of vomiting in infants. These children require a UGI examination.
What surgery is done for pyloric stenosis?
A minimally invasive approach to abdominal surgery, called laparoscopy is generally the first choice of surgery for pyloric stenosis.
Is pyloric stenosis inherited?
Pyloric stenosis may be inherited; several members of a family may have had this problem in infancy.
Why does pyloric stenosis cause metabolic alkalosis?
Pyloric stenosis usually results in metabolic alkalosis with associated hypochloremia and hypokalemia due to a loss of hydrogen and chloride ions from vomiting gastric contents.
Is it normal for a baby to projectile vomit occasionally?
Babies may projectile vomit occasionally, but if it happens after every feed, see your doctor right away as it may be due to a blockage caused by thickening of the muscle at the outlet of the stomach.
What is the pathophysiology of pyloric stenosis?
The hallmark of pyloric stenosis is marked hypertrophy and hyperplasia of both the circular and longitudinal muscular layers of the pylorus
