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PYLORIC STENOSIS, CONGENITAL(Hypertrophic Pyloric Stenosis)

PYLORIC STENOSIS, CONGENITAL
(Hypertrophic Pyloric Stenosis)

DESCRIPTION

Congenital pyloric stenosis is a condition of infancy in which encircling muscles at the end of the stomach enlarge and cause obstruction. The pylorus (a muscular tube that carries food from the stomach to the small intestine) is involved. Congenital pyloric stenosis can affect both sexes but is more common in firstborn males. The condition usually begins between 2 and 5 weeks of age, but it can occur as late as 4 months.
Appropriate health care includes:
  • Physician's monitoring of general condition and medications.
  • Surgery to cut the thickened muscle (pyloromyotomy).
  • Hospitalization for about 3 days after surgery.

    SIGNS & SYMPTOMS

  • Recurrent vomiting after feedings that becomes increasingly forceful.
  • Muscular mass in the upper abdomen (sometimes).
  • No pain or fever. The 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 baby's stomach.

    RISK FACTORS
    Family history of pyloric stenosis.

    PREVENTING COMPLICATIONS OR RECURRENCE

    Cannot be prevented at present.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory blood counts and studies of fluids and electrolytes.
  • X-rays of the stomach (sometimes).

    POSSIBLE COMPLICATIONS

    Weight loss, dehydration, shock, and death without treatment.

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

    TREATMENT

    HOME CARE

    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.
  • See Medications section for information regarding medicines your doctor may prescribe.

    ACTIVITY
    No restrictions.

    DIET & FLUIDS
    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.

    OK TO GO TO SCHOOL?

    When strength and feeling of well-being will allow.

    CALL YOUR DOCTOR IF

  • Your baby vomits repeatedly.
  • The following occurs after surgery: -- Pain, swelling, redness, bleeding, or drainage at the surgical site. -- Temperature spike (sudden rise) to 101F (38.3C). ‡
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