Pyloric Stenosis

• Pyloric Stenosis


  GI disorder involving the narrowing of pyloric sphincter
• Pathognomonic sign of Pyloric Stenosis: Olive-shaped mass with upper abdominal distention
• Vomitus in Pyloric Stenosis: blood-tinged, with gastric content, NO BILE
• Pyloric Stenosis S/Sx:

  • Regurgitation, vomitus, weight loss, malnutrition
  • No anorexia, with good appetite, but vomiting, dehydration
  • Upper abdominal distention: olive-shaped mass
  • Visible gastric peristaltic waves: left to right
  • ABG: Metabolic alkalosis
• Management of Pyloric Stenosis

  • Monitor feeding patterns
  • Assess the vomitus (without bile)
  • Increase OFI (enhance digestion)
  • Prevent aspiration: feeding slowly
  • Burp frequently
  • Position: high Fowler’s (prevent regurgitation)Fowler’s
• Surgical management of Pyloric Stenosis:

  Pyloromyotomy - incision that splits the obstruction; cutting the muscle layer of the pyloric sphincter
• Surgical management of Pyloric Stenosis:

  Pyloromyotomy or Fredet Ramstedt Procedure
• Pyloric Stenosis

  Dx - barium swallow