Pyloric stenosis
Pyloric stenosis typically presents in the second to fourth weeks of life with vomiting, although rarely may present later at up to four months. It is caused by hypertrophy of the circular muscles of the pylorus
Epidemiology
Features
Diagnosis is most commonly made by ultrasound
Management is with Ramstedt pyloromyotomy
Epidemiology
- incidence of 4 per 1,000 live births
- 4 times more common in males
- 10-15% of infants have a positive family history
- first-borns are more commonly affected
Features
- 'projectile' vomiting, typically 30 minutes after a feed
- constipation and dehydration may also be present
- a palpable mass may be present in the upper abdomen
- hypochloraemic, hypokalaemic alkalosis due to persistent vomiting
Diagnosis is most commonly made by ultrasound
Management is with Ramstedt pyloromyotomy