Pyloric Stenosis

Question 1

History taking for pyloric stenosis.

Answer 1

Projectile vomiting beginning at 2-3 weeks old.
Insatiable appetite
Weight loss
Dehydration/constipation

Question 2

Pyloric Stenosis physical exam findings.

Answer 2

Nonbilious vomiting after eating
Olive shaped mass palpated in the epigastrium (right of midline)
Reverse peristalsis visualized across the abdomen.

Question 3

Pyloric stenosis diagnostic studies

Answer 3

Ultrasound to measure pyloric muscle thickness

UGI series demonstrates a “string sign” indicating a fine, elongated pyloric canal.

Question 4

Pyloric stenosis management

Answer 4

Surgical intervention - pyloromyotomy) after correction of fluid and electrolyte imbalance.
Vomiting can continue a few days after surgery.
Prognosis is excellent