Pyloric stenosis: Difference between revisions

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{{Short description|A condition affecting the gastrointestinal tract in infants}}
{{SI}}
 
{{Infobox medical condition
'''Pyloric stenosis''' is a condition that affects the gastrointestinal tract in infants, characterized by the narrowing of the pylorus, the opening from the stomach into the small intestine. This condition leads to severe projectile vomiting, dehydration, and weight loss in affected infants.
| name            = Pyloric stenosis
 
| image          = [[File:Gray1046.svg|left|thumb|200px]]
==Pathophysiology==
| caption        = Diagram of the stomach, showing the pylorus at the lower right
The pylorus is a muscular valve that regulates the passage of food from the stomach to the duodenum. In pyloric stenosis, the muscles of the pylorus become hypertrophied, leading to a narrowing of the pyloric channel. This hypertrophy obstructs gastric emptying, causing the stomach contents to be forcefully expelled.
| field          = [[Gastroenterology]]
 
| synonyms        = Infantile hypertrophic pyloric stenosis (IHPS)
==Epidemiology==
| symptoms        = [[Projectile vomiting]], [[dehydration]], weight loss
Pyloric stenosis is more common in males than females, with a male-to-female ratio of approximately 4:1. It typically presents in infants between 2 to 8 weeks of age. The condition is more prevalent in first-born children and has a higher incidence in Caucasian populations.
| complications  = [[Electrolyte imbalance]], [[malnutrition]]
 
| onset          = 2 to 12 weeks of age
==Clinical Presentation==
| duration        = Chronic without treatment
Infants with pyloric stenosis often present with:
| causes          = Unknown, possibly genetic and environmental factors
* Projectile vomiting: Non-bilious vomiting that occurs shortly after feeding.
| risks          = Male sex, family history, [[macrolide]] antibiotics
* Dehydration: Due to loss of fluids from vomiting.
| diagnosis      = [[Ultrasound]], [[barium swallow]]
* Weight loss: Resulting from inadequate nutrition and fluid intake.
| differential    = [[Gastroesophageal reflux disease]], [[intestinal atresia]], [[metabolic disorders]]
* Palpable "olive": A firm, mobile mass in the right upper quadrant of the abdomen, representing the hypertrophied pylorus.
| treatment      = [[Pyloromyotomy]]
 
| medication      = [[Atropine]] (rarely used)
| prognosis      = Excellent with treatment
| frequency      = 1 to 4 per 1,000 live births
}}
'''Pyloric stenosis''' is a condition in which the opening between the stomach and small intestine thickens. This condition can lead to severe vomiting, dehydration, and weight loss. It is most commonly seen in infants.
==Signs and Symptoms==
[[File:Pyloric-stenosisLocal.jpg|left|thumb|Ultrasound image showing pyloric stenosis.]]
The primary symptom of pyloric stenosis is projectile vomiting, which typically occurs after feeding. Other symptoms may include:
* Dehydration
* Weight loss
* Constant hunger
* Stomach contractions
==Causes==
The exact cause of pyloric stenosis is unknown, but it is believed to involve a combination of genetic and environmental factors. It is more common in males than females and tends to run in families.
==Diagnosis==
==Diagnosis==
The diagnosis of pyloric stenosis is primarily clinical, supported by imaging studies.  
Diagnosis of pyloric stenosis is typically made through a combination of physical examination and imaging studies. An [[ultrasound]] is often used to confirm the diagnosis by showing the thickened pylorus.
 
==Treatment==
===Ultrasound===
[[File:Pyloromyotomie.jpg|left|thumb|Surgical procedure of pyloromyotomy.]]
[[Ultrasound]] is the preferred imaging modality, revealing a thickened pyloric muscle and elongated pyloric channel. The "target sign" or "doughnut sign" is often described on transverse imaging.
The standard treatment for pyloric stenosis is a surgical procedure called [[pyloromyotomy]]. This procedure involves splitting the muscle of the pylorus to relieve the obstruction.
 
===Surgical Procedure===
===Barium Swallow===
[[File:PyloricStenosisHorizontal.jpg|left|thumb|Illustration of pyloric stenosis.]]
A [[barium swallow]] study may show a "string sign," indicating a narrowed pyloric channel.
The pyloromyotomy can be performed as an open surgery or laparoscopically. The laparoscopic approach is less invasive and involves smaller incisions.
 
==Management==
The definitive treatment for pyloric stenosis is surgical intervention.
 
===Pyloromyotomy===
The standard surgical procedure is a [[pyloromyotomy]], where the outer layer of the pylorus muscle is split, allowing the inner mucosa to bulge out and relieve the obstruction. This procedure can be performed via an open or laparoscopic approach.
 
===Preoperative Care===
Before surgery, it is crucial to correct dehydration and electrolyte imbalances. Intravenous fluids are administered to stabilize the infant.
 
==Prognosis==
==Prognosis==
With appropriate surgical treatment, the prognosis for infants with pyloric stenosis is excellent. Most infants recover fully and have no long-term complications.
With appropriate surgical treatment, the prognosis for infants with pyloric stenosis is excellent. Most infants recover quickly and have no long-term complications.
 
==See also==
==Related pages==
* [[Gastrointestinal tract]]
* [[Gastrointestinal tract]]
* [[Infant vomiting]]
* [[Infant vomiting]]
* [[Hypertrophy]]
* [[Dehydration]]
* [[Surgical procedures]]
[[Category:Digestive system disorders]]
 
[[Category:Congenital disorders]]
[[Category:Congenital disorders of digestive system]]
[[Category:Pediatrics]]

Latest revision as of 01:02, 14 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Pyloric stenosis
Synonyms Infantile hypertrophic pyloric stenosis (IHPS)
Pronounce N/A
Specialty N/A
Symptoms Projectile vomiting, dehydration, weight loss
Complications Electrolyte imbalance, malnutrition
Onset 2 to 12 weeks of age
Duration Chronic without treatment
Types N/A
Causes Unknown, possibly genetic and environmental factors
Risks Male sex, family history, macrolide antibiotics
Diagnosis Ultrasound, barium swallow
Differential diagnosis Gastroesophageal reflux disease, intestinal atresia, metabolic disorders
Prevention N/A
Treatment Pyloromyotomy
Medication Atropine (rarely used)
Prognosis Excellent with treatment
Frequency 1 to 4 per 1,000 live births
Deaths N/A


Pyloric stenosis is a condition in which the opening between the stomach and small intestine thickens. This condition can lead to severe vomiting, dehydration, and weight loss. It is most commonly seen in infants.

Signs and Symptoms[edit]

File:Pyloric-stenosisLocal.jpg
Ultrasound image showing pyloric stenosis.

The primary symptom of pyloric stenosis is projectile vomiting, which typically occurs after feeding. Other symptoms may include:

  • Dehydration
  • Weight loss
  • Constant hunger
  • Stomach contractions

Causes[edit]

The exact cause of pyloric stenosis is unknown, but it is believed to involve a combination of genetic and environmental factors. It is more common in males than females and tends to run in families.

Diagnosis[edit]

Diagnosis of pyloric stenosis is typically made through a combination of physical examination and imaging studies. An ultrasound is often used to confirm the diagnosis by showing the thickened pylorus.

Treatment[edit]

Surgical procedure of pyloromyotomy.

The standard treatment for pyloric stenosis is a surgical procedure called pyloromyotomy. This procedure involves splitting the muscle of the pylorus to relieve the obstruction.

Surgical Procedure[edit]

Illustration of pyloric stenosis.

The pyloromyotomy can be performed as an open surgery or laparoscopically. The laparoscopic approach is less invasive and involves smaller incisions.

Prognosis[edit]

With appropriate surgical treatment, the prognosis for infants with pyloric stenosis is excellent. Most infants recover quickly and have no long-term complications.

See also[edit]