Pyloric stenosis

DEFINITION
CAUSES
SIGNS AND SYMPTOMS
MANAGEMENT

1. PYLORIC STENOSIS

2. TABLE OF CONTENTS DEFINITION CAUSES SIGNS AND SYMPTOMS MANAGEMENT MEDICAL MANAGEMENT SURGICAL MANAGEMENT

3. DEFINITION Pyloric stenosis is the hypertrophy of sphincter muscles of the pylorus.

4. CAUSES Previous duodenal ulceration Carcinoma Seen most often in firstborn children

5. SIGNS AND SYMPTOMS Projectile vomiting Vomiting is followed immediately by eagerness to take food Loss of weight The peristaltic waves can be seen across abdomen passing from right to left and reverse immediately prior to vomiting Symptoms usually appear in the second or third week of life and seldom develop after 3-4 months of age. Tumor mass may be felt in the RUQ of the infant’s abdomen.

6. MANAGEMENT

7. MEDICAL MANAGEMENT Small frequent feed and cereals may be substituted for some of the milk, since solid foods are less easily vomited. Provide quiet and relaxed environment to the infant. Provide extra warmth to infant. Very gentle rocking prior and immediately following meals to avoid the infant becomes upset. Small amounts of sedative drugs such as Phenobarbital or the alkaloids of belladonna such as atropine are given in regular doses several times a day, usually preceding meals.

8. SURGICAL MANAGEMENT Pylorotomy or Ramstedt operation It consists of incision in to the sphincter muscle of the pylorus. NG tube is passed and gastric contents are aspirated just prior to surgery. Since only the muscle layers are cut and the stomach is not entered during surgery, permit the infant to have water and sometimes formula as soon as he /she reacted completely from the anesthesia.

9. THE END