PYLORIC STENOSIS, CONGENITAL

General Information

DEFINITION--A condition of infancy in which encircling muscles at the end of the stomach enlarge and cause obstruction.

BODY PARTS INVOLVED--Pylorus (a muscular tube that carries food from the stomach to the small intestine).

SEX OR AGE MOST AFFECTED

• Both sexes, but more common in firstborn males.
• Usually begins between 2 and 5 weeks of age, but can occur as late as 4 months.

SIGNS & SYMPTOMS

• Recurrent vomiting after feedings that becomes increasingly forceful.
• Muscular mass in the upper abdomen (sometimes).
• No pain or fever. Infant seems happy but hungry after vomiting.
• Constipation.
• Gradual weight loss and dehydration.

CAUSES--The muscular band that encircles the pylorus thickens and eventually closes off the outlet from the stomach.

RISK INCREASES WITH--Family history of pyloric stenosis.

HOW TO PREVENT--Cannot be prevented at present.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Barium-swallow x-ray or ultrasound (See Glossary) may be used for confirmation.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Surgery to cut the thickened muscle (pyloromyotomy)
• Hospitalization for about 3 days after surgery.

POSSIBLE COMPLICATIONS--Weight loss, dehydration, shock and death without treatment.

PROBABLE OUTCOME--Curable with surgery. The child usually recovers quickly.

How To Treat

GENERAL MEASURES----After surgery:

• A firm ridge will appear at the incision site. This is a healthy sign and requires no treatment.
• Wash the incision site gently several times a day.
• If the baby seems uncomfortable, apply warm compresses to the incision site.

MEDICATION--Intravenous fluids and electrolytes until the baby is ready for surgery. Medication is usually not necessary after surgery.

ACTIVITY--No restrictions.

DIET--The baby may tolerate small feedings of half-strength formula while awaiting surgery--check with your doctor. If not, formula will be given by stomach tube.

Call Your Doctor If

• Your baby vomits repeatedly.
• The following occurs after surgery: Swelling, redness, bleeding or drainage at the surgical site. Temperature rises to 101F (38.3C).