| Pyloric Stenosis | |
|---|---|
 | |
| Outline of stomach, showing its anatomical landmarks, including the pylorus. | |
| Specialty | General surgery |
| Symptoms | Projectile vomiting after feeding[1] |
| Complications | Dehydration, electrolyte problems[1] |
| Usual onset | 2 to 12 weeks old[1] |
| Causes | Unknown[2] |
| Risk factors | Cesarean section, preterm birth, bottle feeding, first born[3] |
| Diagnostic method | physical examination,[1] ultrasound[4] |
| Differential diagnosis | Gastroesophageal reflux,[1] intussusception[5] |
| Treatment | Surgery[1] |
| Prognosis | Excellent[1] |
| Frequency | 1.5 per 1,000 babies[1] |
Pyloric stenosis is a narrowing of the opening from the stomach to the first part of the small intestine (the pylorus).[1] Symptoms include projectile vomiting without the presence of bile.[1] This most often occurs after the baby is fed.[1] The typical age that symptoms become obvious is two to twelve weeks old.[1]
The cause of pyloric stenosis is unclear.[2] Risk factors in babies include birth by cesarean section, preterm birth, bottle feeding, and being firstborn.[3] The diagnosis may be made by feeling an olive-shaped mass in the baby's abdomen.[1] This is often confirmed with ultrasound.[4]
Treatment initially begins by correcting dehydration and electrolyte problems.[1] This is then typically followed by surgery, although some treat the condition without surgery by using atropine.[1] Results are generally good in both the short term and the long term.[1]
About one to two per 1,000 babies are affected, and males are affected about four times more often than females.[1] The condition is very rare in adults.[6] The first description of pyloric stenosis was in 1888, with surgical management first carried out in 1912 by Conrad Ramstedt.[1][2] Before surgical treatment, most babies with pyloric stenosis died.[1]
- ^ a b c d e f g h i j k l m n o p q r s Ranells JD, Carver JD, Kirby RS (2011). "Infantile hypertrophic pyloric stenosis: epidemiology, genetics, and clinical update". Advances in Pediatrics. 58 (1): 195–206. doi:10.1016/j.yapd.2011.03.005. PMID 21736982.
- ^ a b c Georgoula C, Gardiner M (August 2012). "Pyloric stenosis a 100 years after Ramstedt". Archives of Disease in Childhood. 97 (8): 741–5. doi:10.1136/archdischild-2011-301526. PMID 22685043. S2CID 2780184.
- ^ a b Zhu J, Zhu T, Lin Z, Qu Y, Mu D (September 2017). "Perinatal risk factors for infantile hypertrophic pyloric stenosis: A meta-analysis". Journal of Pediatric Surgery. 52 (9): 1389–1397. doi:10.1016/j.jpedsurg.2017.02.017. PMID 28318599.
- ^ a b Pandya S, Heiss K (June 2012). "Pyloric stenosis in pediatric surgery: an evidence-based review". The Surgical Clinics of North America. 92 (3): 527–39, vii–viii. doi:10.1016/j.suc.2012.03.006. PMID 22595707.
- ^ Marsicovetere P, Ivatury SJ, White B, Holubar SD (February 2017). "Intestinal Intussusception: Etiology, Diagnosis, and Treatment". Clinics in Colon and Rectal Surgery. 30 (1): 30–39. doi:10.1055/s-0036-1593429. PMC 5179276. PMID 28144210.
- ^ Hellan M, Lee T, Lerner T (February 2006). "Diagnosis and therapy of primary hypertrophic pyloric stenosis in adults: case report and review of literature". Journal of Gastrointestinal Surgery. 10 (2): 265–9. doi:10.1016/j.gassur.2005.06.003. PMID 16455460. S2CID 25249604.