What manifestations would a patient with acquired pyloric stenosis likely present with?
Overview Show The pylorus is a muscular valve located between the stomach and the small intestine. It’s the exit point of the stomach and the gateway to the duodenum of the small intestine. It helps the stomach hold food, liquids, acids, and other matter until they are ready to move on to the small intestine and be further digested and then absorbed. For reasons that aren’t entirely understood, the pylorus can sometimes thicken and cause luminal narrowing. This is called pyloric stenosis. This thickening can become so large that it blocks the flow of food from the stomach to the small intestine. Pyloric stenosis is most likely to affect young babies. It’s found in 2 to 3 out of every 1,000 babies. It most often appears in the first 2 to 8 weeks of life, although it can occur in babies up to 6 months of age. The condition interferes with feedings, so it can affect growth and hydration. That’s why early diagnosis and treatment are important. Gastrointestinal issues are the main symptoms of pyloric stenosis. Most babies with this condition appear fine at birth. Symptoms typically begin and become progressively worse during the first few months of life. Symptoms may include:
Unlike with a stomach bug, babies with pyloric stenosis generally don’t seem as sick in between feedings. Pyloric stenosis is not common. Certain babies are more prone to it than others. Things that put a baby at risk are:
When pyloric stenosis is suspected, your baby’s doctor will take a thorough history and perform a physical exam of your child’s abdomen. If the doctor can feel a thickened pylorus muscle, which may feel like an olive, no further tests may be needed. If the doctor cannot feel the pylorus, they may order an abdominal ultrasound to examine the abdominal tissue in order to see the pylorus. The doctor may also want X-ray imaging taken after your baby drinks a contrasting liquid to help improve clarity of the images. This oral contrasted X-ray can show how the liquid travels from the stomach to the small intestine and show if there is a blockage.
Pyloric stenosis needs to be treated. It won’t improve on its own. Your child will need surgery called pyloromyotomy. During this surgery, which can be done laparoscopically, a surgeon will cut through part of the thickened muscle in order to restore a pathway for food and liquid to pass through. If your baby is dehydrated because of frequent and forceful vomiting, they may need to be hospitalized and given fluid through an intravenous needle inserted into a vein (IV fluid) before surgery. Once properly hydrated, your baby will have to refrain from feedings for several hours to reduce the risk of vomiting while under anesthesia. The surgery itself usually takes less than hour, but your baby will likely stay in the hospital for 24 to 36 hours. Most babies do fine after surgery. Feedings are gradually resumed, and pain is generally managed with over-the-counter pain relievers. It’s normal for babies to vomit a little in the first few hours and days after the surgery as the stomach settles down. This condition can affect your child’s nutritional and hydration needs, so it’s important to seek medical help whenever your baby has feeding difficulties. The condition can be successfully corrected with surgery, and most infants will go on to grow and thrive just like other babies. What is pyloric stenosis and what is its characteristic symptom?Pyloric stenosis is a thickening or swelling of the pylorus — the muscle between the stomach and the intestines — that causes severe and forceful vomiting in the first few months of life. It is also called infantile hypertrophic pyloric stenosis.
What are the signs and symptoms of pyloric stenosis in adults?Conclusion: Adult Idiopathic hypertrophic pyloric stenosis (AIHPS) is a rare disease which is also underreported due to a difficulty in diagnosis. The most common symptoms of AIHPS are postprandial nausea, vomiting, early satiety, and epigastric pain as seen in our patient.
What is the classic presentation of pyloric stenosis?Infants with pyloric stenosis classically present with projectile, non bilious vomiting. Vomiting may be intermittent or occur after each feeding.
What is the classic presentation of a patient with hypertrophic pyloric stenosis?Typical presentation of an infant with hypertrophic pyloric stenosis (HPS) is onset of initially nonbloody, always nonbilious vomiting at 4-8 weeks. Although vomiting may initially be infrequent, over several days it becomes more predictable, occurring at nearly every feeding.
|