2: GI: Pyloric Stenosis Flashcards
What is pyloric stenosis
hypertrophy and hyperplasia of pyloric sphincter
What is the commonest cause of gastric outlet obstruction in children
pyloric stenosis
What age does gastric outlet obstruction occur
3-8 weeks
Which gender is gastric outlet obstruction occur more commonly in
Males
What are 4 risk factors for pyloric stenosis
- FH
- In-utero smoking
- Macrolides in first 2W life
- Bottle fed
What is the clinical presentation of pyloric stenosis
- Projectile non-bilious vomiting following
feeds - Neonate continually hungry and wants to
continue feed - Constipation
How is vomit in pyloric stenosis distinguished
Non-billous
Projectile
Describe neonates appetite in pyloric stenosis
Continually hungry
Wants to re-feed
Describe feeding in pyloric stenosis
Takes large volume feed in minutes
What is a clinical feature of pyloric stenosis on examination
Olive-shaped mass in epigastrium
Peristalsis left to right UQ (late-sign)
Explain metabolic changes in pyloric stenosis
Vomiting causes dehydration and hypochloraemia. To try and retain fluid, Na+ is retained in exchanged for potassium causing hypokalaemia. This causes potassium to move out of cells in exchange for H+ which moves in cells causing metabolic alkalosis
What are metabolic changes in pyloric stenosis
- Hypochloraemia
- Metabolic alkalosis
- Hypokalaemia
Aside from ABG, what may be used to investigate pyloric stenosis
AUS
what will be seen on AUS in pyloric stenosis
Thickened and hypertrophied pylorus
explain management of pyloric stenosis
- NG tube
- Correct electrolytes
- Pyloromyotomy
