pyloric stenosis

Question 1

definition

Answer 1

congenital disorder where at birth the pylorus is normal but after a few weeks the smooth muscle cells of the pyloric antrum undergo hyperplasia and hypertrophy causing the pyloric antrum to nearly double in size causing difficulty of food passive from the somtach into the duodenum causing a gastric outflow obstruction

Question 2

the obstruction results in

Answer 2

the build up go gastric contents causing progressive vomiting eventually causing PROJECTILE VOMITING

Question 3

pathopneumonic for pyloric stenosis

Answer 3

projectile vomiting which is non-billous

Question 4

clinically

Answer 4

the enlarged pylorus can be palpated as an OLIVE in the right upper quadrant or the epigastrium

Question 5

vomiting results in loss of stomach acid which causes

Answer 5

• dehydration resulting in the kidney retaining sodium and excreting potassium causing a metabolic alkalosis
• loss of hydrochloric acid which depletes the bodies chloride stores causing hypochloraemia

Question 6

diagnosis

Answer 6

• palpation of olive mass in the right upper quadrant or the epigastrium
• visible peristalsis
• ultrasound shows the muscle wall thickness of greater than 3mm of the pyloric muscle or the length of the pylorus is greater than 15-17mm

Question 7

treatment

Answer 7

• correction of electrolyte abnormalities

- ramsteds pyloromyotomy