Pyloric stenosis

Revision as of 23:19, 29 October 2010 by Robot (talk | contribs) (Created page with "==Background== * more common in males & 1st born children. d/t pyloric hypertrophy in 1st mos of life (usu 3-6 wks, w/ a range of 1-10 wks) * rare in 1st days of life ==Diag...")
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Background

  • more common in males & 1st born children. d/t pyloric hypertrophy in 1st mos of life (usu 3-6 wks, w/ a range of 1-10 wks)
  • rare in 1st days of life


Diagnosis

  • S/S: vomiting (often projectile), ask if blurp up milk or clears the clothes. infant hungry but vomits soon after eating w/ NEVER any bile, maybe some blood. constipation, olive in RUQ to mid quadrant, occ see peristaltic waves
  • Labs might show a low K, Low Cl, & hypo-Cl alkolosis
  • AXR w/ lg stomach bubble may suggest gastric obstruction but usu nl
  • U/S used to look at dm of pylorus, UGI shows "string sign" from narrow pylorus


Treatment

  • NGT, IVF (do NOT give LR b/c more alkalotic & infant already vomiting up all its HCl, alkalosis can= apnea in infants!), after initial NS can give D5NS w/ KCl, surgery needed (pyloromyotomy) but can be delayed 24-36 hr to reydrate infant
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