Symptoma

Congenital Pyloric Stenosis

[…] if the condition was present at the time of inpatient admission. [icd.codes]

Concomitant anomalies and postoperative complications found in this series are presented. The efficacy of surgical treatment is emphasized. [ncbi.nlm.nih.gov]

USG is the investigation of choice- features present in the pyloric canal can be seen. [medicinembbs.blogspot.com]

  • Weight Loss

    Projectile vomiting (non bile-stained fluid) Weight loss, child becomes emaciated and dehydrated. Hypertrophied pylorus is palpated in the epigastrium (“olive”). It’s mobile, smooth, firm mass with well defined borders. [medicinembbs.blogspot.com]

    You should see a doctor if you have any of the following: Blood when you have a bowel movement Severe abdominal pain Heartburn not relieved by antacids Unintended weight loss Ongoing vomiting or diarrhea NIH: National Institute of Diabetes and Digestive [icdlist.com]

    CLINICAL PRESENTATION  History: 2nd - 8th week of life  Projectile, frequent episodes of non-bilious vomiting 30-60 minutes after feeding  Weight loss  Persistent hunger  Jaundice (2%)- due to decreased hepatic glucoronosyl transferase associated [slideshare.net]

    Depending on the duration of symptoms, patients may suffer significant weight loss, even falling below birth weight. [mdedge.com]

    The anamnesis did not reveal any abdominal distension, weight loss or previous medication. The medical history Chapter was not contributory. The clinical examination performed on a dehydrated infant revealed an epigastric arch. [springerplus.springeropen.com]

  • Irritable Infant

    This mass is palpable to an experienced examiner in up to 80% to 90% of cases, but may be difficult to appreciate in the face of a dilated stomach or irritable infant. [basicmedicalkey.com]

  • Hunting

    It may be only for a day or a week, but the cessation of vomiting suggests that the disturbance is due to the food, that the appropriate food has not been found, and so the hunt continues. [chestofbooks.com]

  • Gastric Lavage

    Gastric lavage is useful in two ways, first in removing all irritating remnants of food from the stomach, and secondly in showing the physician how to regulate successfully the food and feeding. [chestofbooks.com]

  • Vomiting

    Two days later the baby was brought again to the family practitioner with a history that he has been vomiting almost every feed and the vomiting was projectile immediately following each feed. [medindia.net]

    After vomiting, the infant is hungry and wants to feed again. As vomiting continues, a progressive loss of fluid, hydrogen ion, and chloride leads to hypochloremic metabolic alkalosis. [clinicalgate.com]

    The history is usually as follows : An infant, healthy at birth, seems to progress satisfactorily for two, three, or five weeks, and then vomiting comes on. It does not matter what the food is, breast or artificial feeding, the vomiting persists. [chestofbooks.com]

    The features of projectile vomiting, a pyloric olive and visible peristalsis were studied and their clinical and diagnostic significance was compared with that of radiological investigations. [ncbi.nlm.nih.gov]

    Abnormal or frequent vomiting, may suggest an incomplete myotomy or a missed perforation. [basicmedicalkey.com]

  • Projectile Vomiting

    The features of projectile vomiting, a pyloric olive and visible peristalsis were studied and their clinical and diagnostic significance was compared with that of radiological investigations. [ncbi.nlm.nih.gov]

    At the age of 3 to 6 weeks, particularly in a male chid projectile vomiting should raise the suspicion of congenital hypertrophic pyloric stenosis. [medindia.net]

    Projectile vomiting (non bile-stained fluid) Weight loss, child becomes emaciated and dehydrated. Hypertrophied pylorus is palpated in the epigastrium (“olive”). It’s mobile, smooth, firm mass with well defined borders. [medicinembbs.blogspot.com]

    Clinical signs and symptoms appear early in life and include projectile vomiting and dehydration. Narrowing of the pyloric canal due to hypertrophy of the surrounding circular muscle. It is usually seen in infants or young children. [icd10data.com]

    Hypertrophic pyloric stenosis should be suspected in all infants in the first several months of life with projectile vomiting. [merckmanuals.com]

  • Persistent Vomiting

    Due to the loss of hydrochloric acid in the gastric contents from persistent vomiting, patients are at risk of electrolyte imbalance, specifically the characteristic hypochloremic metabolic alkalosis. [radiopaedia.org]

    Persistent vomiting is most often a result of esophagitis or gastritis and is managed by stopping the feedings for several hours, and then restarting feedings at low volume. [basicmedicalkey.com]

    vomiting expectantly because it usually resolves within 1-2 days Avoid the temptation to repeat ultrasonography or upper GI barium study; these invariably demonstrate a deformed pylorus, and results are difficult to interpret See Treatment and Medication [emedicine.medscape.com]

    Operative complications include mucosal perforation, continued postoperative bleeding (very rare), and persistent vomiting due to incomplete pyloromyotomy (rare). [patient.info]

    Infants with persistent vomiting at the age of 3 5 weeks after birth should be considered IHPS, and go to hospital as soon as possible in order to reduce the incidence of hypokalemia, hypochloraemia and hypercapnia, and avoid deterioration. [journals.plos.org]

  • Gastropathy

    Diffuse esophageal spasm, GERD ) - Esophageal stricture Stomach Peptic (gastric) ulcer - Gastritis ( Atrophic, Ménétrier's disease ) - Gastroenteritis - Dyspepsia - Pyloric stenosis - Achlorhydria - Gastroparesis - Gastroptosis - Portal hypertensive gastropathy [wikidoc.org]

    Increased physiologic and therapeutic prostaglandin levels have been associated previously with reactive gastropathy and gastric outlet obstruction ( 24, 25, 26 ). [nature.com]

  • Vomiting in Infancy

    Infantile or congenital hypertrophic pyloric stenosis is one of the most common surgical causes of vomiting in infancy. [sonoworld.com]

    Of course, clinically it is important to consider other causes of vomiting in infancy. A degree of pylorospasm is common in infancy and is responsible for some delay in gastric emptying. The pylorus, however, appears sonographically normal. [radiopaedia.org]

[…] antrum After upper GI barium study, irrigating and removing any residual barium from the stomach is advisable to avoid aspiration Endoscopy Reserved for patients with atypical clinical signs when ultrasonography and UGI studies are nondiagnostic See Workup [emedicine.medscape.com]

  • Hyponatremia

    ECF volume deficit urinary excretion of K and H to preserve Na and water • Initial alkalotic urine becomes acidotic- Paradoxical aciduria • Hypochloremic hypokalemic metabolic alkalosis with paradoxical aciduria with secondary respiratory acidosis • Hyponatremia [slideshare.net]

The efficacy of surgical treatment is emphasized. [ncbi.nlm.nih.gov]

Learn about this topic in these articles: symptoms and treatment In atresia and stenosis Pyloric stenosis is a spasmodic narrowing of the opening between the stomach and the duodenum. [britannica.com]

Cases are still being frequently overlooked, the proper treatment is not carried out, and the infants die. [chestofbooks.com]

Babies with birth defects often need special care and treatments. The treatments may include surgery, medicines, assistive devices, and therapies. [icdlist.com]

• Treatment: medical emergency but NOT surgical emergency • Definitive treatment: Ramstedt Pyloromyotomy • Anaesthetic considerations • Patient related: infant age group severe dehydration electrolyte imbalance • Surgery related: open/ laparoscopic [slideshare.net]

This condition is known to be rare in Africa, and the cases of late discovery are even rarer in this context because of the early involvement of life prognosis, in the absence of resuscitation. [springerplus.springeropen.com]

[…] gastric emptying of fluid into duodenum Complications Hypochloremic metabolic alkalosis DDx Infantile pylorospasm Muscle thickness between 1.5 and 3 mm Variable caliber of antral narrowing Antral peristalsis Delayed gastric emptying Elongation of pylorus Prognosis [learningradiology.com]

Prognosis The prognosis of pyloric stenosis is very good for those that are diagnosed early and treated with surgery. Life expectancy of infants diagnosed with pyloric stenosis is the same as that of the average individual. [encyclopedia.com]

Prognosis Prognosis is excellent unless diagnosis is delayed and prolonged severe dehydration occurs. Mortality is rare after pyloromyotomy. Peters B, Oomen MW, Bakx R, et al ; Advances in infantile hypertrophic pyloric stenosis. [patient.info]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Peptic ulcer may be an etiologic factor in some instances; however, the presence of a small ulcer is difficult to demonstrate in the majority of clinical cases. Lippincott-Raven Publishers. [journals.lww.com]

Its etiology is probably multifactorial as the pylorus seems sensitive to attack at certain times and in certain subjects. [springerplus.springeropen.com]

EPIDEMIOLOGY AND ETIOLOGY • Incidence: 1-2/1000 live births • Epidemiology: more in first born males M:F - 4-5:1 • Etiology: Unknown • Genetic- 11q14-22 and Xq23 • Familial • Gender • Ethnic origin- more in whites • As new technology and concepts have [slideshare.net]

This is one of the few cases of HPS present at birth, which was diagnosed and surgically treated early, and we suggest a congenital etiology in previously reported cases of HPS. [ncbi.nlm.nih.gov]

EPIDEMIOLOGY AND ETIOLOGY • Incidence: 1-2/1000 live births • Epidemiology: more in first born males M:F - 4-5:1 • Etiology: Unknown • Genetic- 11q14-22 and Xq23 • Familial • Gender • Ethnic origin- more in whites • As new technology and concepts have [slideshare.net]

[2] Synonyms and Keywords: Congenital hypertrophic pyloric stenosis; infantile hypertrophic pyloric stenosis; pyloric stenosis Overview Historical Perspective Classification Pathophysiology Causes Differentiating Pyloric stenosis from other Diseases Epidemiology [wikidoc.org]

Schechter R, Torfs CP, Bateson TF (1997) The epidemiology of infantile hypertrophic pyloric stenosis. Paediatr Perinat Epidemiol 11: 407–427. View Article Google Scholar 8. [journals.plos.org]

The epidemiology of infantile hypertrophic pyloric stenosis. Paediatr Perinat Epidemiol 1997; 11 :407–27. 16. Svenningsson A, Svensson T, Akre O, Nordenskjöld A. [nature.com]

[…] become easily obstructed. [ 1 ] Genetic studies have identified susceptibility loci for infantile hypertrophic pyloric stenosis (IHPS) and molecular studies have concluded that smooth muscle cells are not properly innervated in this condition. [ 2 ] Epidemiology [patient.info]

Pathophysiology Progressive hypertrophy of the circular muscles in the pyloric sphincter. Not present at birth but occurs over 3 to 5 weeks. Clinical Features Common in 1st born male child. [medicinembbs.blogspot.com]

PATHOPHYSIOLOGY • Vomiting loss of H and Cl Hypochloremic hypokalemic metabolic alkalosis • Protracted vomiting ECF volume deficit urinary excretion of K and H to preserve Na and water • Initial alkalotic urine becomes acidotic- Paradoxical aciduria • [slideshare.net]

Likewise, our understanding of the etiology and pathophysiology of duodenal obstruction and malrotation has been largely stagnant. [basicmedicalkey.com]

M.D. [1] ; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D. [2] Synonyms and Keywords: Congenital hypertrophic pyloric stenosis; infantile hypertrophic pyloric stenosis; pyloric stenosis Overview Historical Perspective Classification Pathophysiology [wikidoc.org]

Centers for Disease Control and Prevention Intersex (Medical Encyclopedia) [ Read More ] Stomach Disorders Also called: Gastric disorders Your stomach is an organ between your esophagus and small intestine. It is where digestion of protein begins. [icdlist.com]

[…] fluid deficits- over 24-48 hrs • Deficit: isotonic fluid 0.9% saline (20ml/kg bolus) • Maintenance: 0.45% saline in 5% Dextrose at 1.5 times maintenance rate 10-40 meq/L KCL added once urine output established • Correction of electrolyte imbalances • Prevention [slideshare.net]

Last updated May 6, 2018 BruceBlaus Pyloric Stenosis is the thickening of the muscle layer of the pyloric region resulting in the narrowing of the pyloric sphincter, which prevents the food from leaving the stomach. [dovemed.com]

Secondary Prevention Cost-Effectiveness of Therapy Future or Investigational Therapies Case Studies Case#1 v t e Digestive system - Digestive disease - Gastroenterology (primarily K20-K93, 530-579 ) Upper GI tract Esophagus Esophagitis ( Candidal ) - [wikidoc.org]

Prevention It is not known how to prevent pyloric stenosis. Resources Books Behrman, Richard E., et al., Nelson Textbook of Pediatrics. Philadelphia: WB Saunders, 2000. Periodicals Yoshizawa J, et al. [medical-dictionary.thefreedictionary.com]