Pyloric Stenosis: Causes and Diagnosis

Pyloric Stenosis refers to the narrowing of the opening between the stomach and the first part of the small intestine. This blocks food from entering the small intestine. In pyloric stenosis, the pylorus muscles thicken and becomes abnormally large, blocking food from entering the small intestine and this leads to forceful vomiting which is projectile.

It is sometimes called infantile hypertrophic pyloric stenosis, is a condition that affects infants. It occurs mainly between the age of 2 weeks to 12 weeks after birth, although it can also occur at anytime from birth to 6 months of age. Pyloric stenosis can be corrected with surgery and/or medication in some cases.

 

 

 

The condition is rare and affects about 2-3 infants in 1000. It is also more common in male infants than female infants. The blockage of the stomach food content from entering the small intestine is responsible for the severe dehydration, weight loss and electrolyte imbalance the child experiences.

 

 

 

Causes and Symptoms

The cause is unknown, but genetic and environmental factors have been shown to play a role in its development.

There are some risk factors however, that can increase the chances of an infant developing pyloric stenosis. They include,

  • Sex (boys).
  • Race (African-American, Asians).
  • Preterm birth.
  • Family history.
  • Being first born.
  • Birth by Ceasarian section.

 

Common symptoms and signs in infants include the following :

  • Forceful projectile vomiting which does not contain bile, especially after feeding.
  • Persistent hunger.
  • Moderate to severe dehydration.
  • Stomach contraction.
  • Weight loss

 

 

 

Diagnosis and Treatment

Diagnosis of is made at the hospital after the doctor has taken a detailed history of the baby and conducted a physical examination on the child.

An urgent ultrasound scan is done in addition to the physical examination which will show the blockage of the stomach food content.

Surgery is needed to treat and correct the narrowing of the opening between the stomach and the first part of the small intestine. The procedure is called Pyloromyotomy which is a minimally invasive procedure. The surgery have very excellent prognosis and the baby grows to have a normal life.

However, before the surgery is carried out, the baby will first be admitted to correct any electrolyte imbalance caused by dehydration with intravenous fluids. This should take between 24 to 48 hours.

Atropine can also be used in the treatment in infants. Major complications may include;

  • Failure to thrive.
  • Dehydration
  • Electrolyte imbalance.
  • Stomach irritation
  • Malnutrition

 

 

 

 

 

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