L2: CHPS

Question 1

Def of CHPS

Answer 1

• Hypertrophy of the pyloric muscle that causes gastric outlet obstruction.

Question 2

Epidemeology of CHPS

Answer 2

Question 3

Epidemeology of CHPS

• Incidence

Answer 3

One in 250 live births 1: 250

Question 4

Epidemeology of CHPS

• Sex

Answer 4

Males 4 : Females 1

Question 5

Epidemeology of CHPS

• Family History

Answer 5

Positive

Question 6

Etiology of CHPS

Answer 6

Question 7

Etiology of CHPS

• Etiological Factors

Answer 7

Question 8

Pathophysiology of CHPS

Answer 8

Question 9

Pathophysiology of CHPS

• Infantile pyloric stenosis is characterized by persistent, non-bilious projectile vomiting, Due to gastric outlet obstruction.

Answer 9

…

Question 10

Prolonged vomiting leads to loss of large quantities of gastric secretions rich in H+ & Cl.

Answer 10

….

Question 11

• As a result of dehydration, kidneys attempt to conserve Nat to maintain volume by exchanging Na* for K* and H* secreted as KHCO, & H,CO, …..

Answer 11

(paradoxical aciduria).

Question 12

Paradoxical Aciduria

Answer 12

There is «metabolic alkalosis, but instead of having an alkalotic urine, it is acidix.

Question 13

CP of CHPS

Answer 13

Question 14

CP of CHPS

• History (symptoms)

Answer 14

• Typically a full-term baby, 3-5 weeks old
• Persistent, gastric, never-bilious, projectile vomiting soon after feeds.
• Failure to thrive, constipation, seizures.

Question 15

CP of CHPS

• Signs

Answer 15

• Pyloric “tumor” in right upper quadrant.
• Visible peristalsis.
• Dehydration late, presentation).

Question 16

CP of CHPS

• Metabolic Abnormalities

Answer 16

• Hypochloremic hypokalemic metabolic alkalosis.
• Paradoxical aciduria due to renal conservation of Na+ leading to loss of H*.
• CO, increase due to the respiratory compensation.

Question 17

INVx for CHPS

Answer 17

• Rads
• Labs

Question 18

INVx for CHPS

• Rads

Answer 18

• US
• Contrast Study

Question 19

INVx for CHPS

• US

Answer 19

Question 20

INVx for CHPS

• Contrast Study

Answer 20

Question 21

INVx for CHPS

• Labs

Answer 21

Question 22

TTT of CHPS

Answer 22

• Pre-operative
• Surgical TTT

Question 23

TTT of CHPS

• Pre-operative

Answer 23

Question 24

TTT of CHPS

• Surgical TTT

Answer 24

Question 25

Done

Answer 25

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