Pyloric Stenosis

Question 1

RF

Answer 1

Male, Fam Hx

Question 2

Presentation

Answer 2

2-4 weeks
Non billious vomiting after every feeds
Projectile vomiting
Weight loss and dehydration

Olive mass palpated RUQ.

Question 3

Investigation

Answer 3

Abdo USS.
NG tube and feeds will induce peristaltic mov on olive mass.

Blood gas as pt low Cl, low K and met alkalosis.

Question 4

Management

Answer 4

Correct metabolic abnormality, fluid bolus 10-20ml/Kg.

Check UE and electrolyte until balances all corrected.

Once balanced, Ramstedts pyloromyotomy procedure can commence, horizontal incision down the muscle leaving mucosa intact.

Question 5

Complications

Answer 5

Infection, apnoea due to metabolic changes, wound dehiscence (perforation).