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]