Pyloric stenosis occurs between 2 and 8 weeks of age (male/female of 4:1). Initially, the child will feed well with gradual increasing nonbilious, projectile emesis. The enlarged pylorus can feel like an olive in the upper abdomen. Typically, the child presents with dehydration and a hypokalemic, hypochloremic metabolic alkalosis. Ultrasound or upper gastrointestinal series may be performed to aid with diagnosis. The primary emphasis should be resuscitation and correcting electrolyte abnormalities. Upon normalization of lab values, the child can be taken to the operating room for an open or laparoscopic pyloromyotomy.
KeywordsPyloric stenosis Nonbilious emesis Projectile vomiting Olive Hypokalemic hypochloremic metabolic alkalosis Pyloromyotomy
- 1.Koontz C, Wulkan M. Lesions of the stomach. In: Holcomb III G, Murphy J, Ostlie D, editors. Ashcraft’s pediatric surgery. 6th ed. London: Elsevier Inc; 2014.Google Scholar
- 2.Schwartz M. Hypertrophic pyloric stenosis. In: Coran A, et al., editors. Pediatric surgery. 7th ed. London: Elsevier Inc; 2012.Google Scholar