3. Congenital pyloric stenosis

Question 1

MCC of gastric oulte obstruction in infants ( and frequency )

Answer 1

Hypertrophic pyloric stenosis (1: 600)

Question 2

presentations and results

Answer 2

Palpable “olive” mass in
epigastric region and nonbilious projectile vomiting at ∼ 2–6 weeks old—> Results in hypokalemic hypochloremic
metabolic alkalosis (2° to vomiting of gastric acid and subsequent volume contraction). Treatment
is surgical incision (pyloromyotomy)

Question 3

associated with

Answer 3

• exposure to macrolide

- more common in firstborn males

Question 4

treatment

Answer 4

surgical incision (pyloromyotomy)

Question 5

• In a patient with congenital pyloric stenosis, hypertrophy of the pylorus leads to what problem?

Answer 5

Gastric outlet obstruction

Question 6

• An infant with projectile vomiting is found to have a palpable, epigastric, olive-sized mass is found on physical exam. Name this condition.

Answer 6

Congenital pyloric stenosis

Question 7

• In a baby with suspected congenital pyloric stenosis, what type of vomit would rule out the disorder?

Answer 7

Bilious (bilious vomit originates distal to the pyloric sphincter)

Question 8

• A 3-week-old baby has projectile nonbilious vomiting and a normal physical exam. What treatment will likely be indicated?

Answer 8

Surgical pyloromyotomy (with pyloric stenosis, the classic “olive mass” is often not palpable)

Question 9

• Congenital pyloric stenosis often occurs in what demographic group?

Answer 9

Male first-born infants