Pyloric stenosis: Difference between revisions

Revision as of 14:13, 21 February 2025

Pyloric Stenosis

Diagram of the stomach showing the pylorus.

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

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 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

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

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

File:Laparoscopic Pyloromyotomy scar, 6hrs post-op.jpg

Scar from laparoscopic pyloromyotomy, 6 hours post-operation.

Prognosis

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

Related Pages

@@ Line 1: / Line 1: @@
-{{Short description|A condition affecting the gastrointestinal tract in infants}}
+Pyloric Stenosis
-'''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.
+[[File:Gray1046.svg|thumb|right|Diagram of the stomach showing the pylorus.]]
-==Pathophysiology==
+'''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.
-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.
-==Epidemiology==
+==Signs and Symptoms==
-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.
-==Clinical Presentation==
+[[File:Pyloric-stenosisLocal.jpg|thumb|left|Ultrasound image showing pyloric stenosis.]]
-Infants with pyloric stenosis often present with:
-* Projectile vomiting: Non-bilious vomiting that occurs shortly after feeding.
+The primary symptom of pyloric stenosis is projectile vomiting, which typically occurs after feeding. Other symptoms may include:
-* Dehydration: Due to loss of fluids from vomiting.
-* Weight loss: Resulting from inadequate nutrition and fluid intake.
+* Dehydration
-* Palpable "olive": A firm, mobile mass in the right upper quadrant of the abdomen, representing the hypertrophied pylorus.
+* 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==
-The diagnosis of pyloric stenosis is primarily clinical, supported by imaging studies.
-===Ultrasound===
+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.
-[[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.
-===Barium Swallow===
+==Treatment==
-A [[barium swallow]] study may show a "string sign," indicating a narrowed pyloric channel.
-==Management==
+[[File:Pyloromyotomie.jpg|thumb|right|Surgical procedure of pyloromyotomy.]]
-The definitive treatment for pyloric stenosis is surgical intervention.
-===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.
-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===
+===Surgical Procedure===
-Before surgery, it is crucial to correct dehydration and electrolyte imbalances. Intravenous fluids are administered to stabilize the infant.
+[[File:PyloricStenosisHorizontal.jpg|thumb|left|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.
+[[File:Laparoscopic_Pyloromyotomy_scar,_6hrs_post-op.jpg|thumb|right|Scar from laparoscopic pyloromyotomy, 6 hours post-operation.]]
 ==Prognosis==
-With appropriate surgical treatment, the prognosis for infants with pyloric stenosis is excellent. Most infants recover fully and have no long-term complications.
-==Related pages==
+With appropriate surgical treatment, the prognosis for infants with pyloric stenosis is excellent. Most infants recover quickly and have no long-term complications.
+==Related Pages==
 * [[Gastrointestinal tract]]
 * [[Infant vomiting]]
-* [[Hypertrophy]]
+* [[Dehydration]]
-* [[Surgical procedures]]
-[[Category:Congenital disorders of digestive system]]
+[[Category:Digestive system disorders]]
-[[Category:Pediatrics]]
+[[Category:Congenital disorders]]
-== Pyloric stenosis ==
-<gallery>
-File:Gray1046.svg|Gray's Anatomy illustration of the stomach
-File:Pyloric-stenosisLocal.jpg|Local view of pyloric stenosis
-File:Pyloromyotomie.jpg|Pyloromyotomy procedure
-File:PyloricStenosisHorizontal.jpg|Horizontal view of pyloric stenosis
-File:Pylorusstenose.jpg|Pylorus stenosis
-File:Laparoscopic Pyloromyotomy scar, 6hrs post-op.jpg|Laparoscopic pyloromyotomy scar, 6 hours post-op
-</gallery>