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Definition

Pyloric stenosis is a narrowing of the pylorus, the opening from the stomach into the small intestine.

Alternative Names

Congenital hypertrophic pyloric stenosis; Hypertrophic pyloric stenosis; Gastric outlet obstruction

Causes, incidence, and risk factors

Normally, food passes easily from the stomach into the duodenum (the first part of the small intestine) through a valve called the pylorus. In pyloric stenosis, the muscles of the pylorus are thickened. This thickening prevents the stomach from emptying into the small intestine.

The cause of the thickening is unknown, although genetic factors may play a role. Children of parents who had pyloric stenosis are more likely to have this problem.

Pyloric stenosis occurs more often in boys than in girls, and is rare in children older than 6 months. The condition is usually diagnosed by the time a child is 6 months old.

Symptoms

Vomiting is the first symptom in most children:

  • Vomiting may occur after every feeding or only after some feedings
  • Vomiting usually starts around 3 weeks of age, but may start any time between 1 week and 5 months of age
  • Vomiting is forceful (projectile vomiting)
  • The infant is hungry after vomiting and wants to feed again

Other symptoms generally appear several weeks after birth and may include:

  • Abdominal pain
  • Belching
  • Constant hunger
  • Dehydration (gets worse with the severity of the vomiting)
  • Failure to gain weight or weight loss
  • Wave-like motion of the abdomen shortly after feeding and just before vomiting occurs
Signs and tests

The condition is usually diagnosed before the baby is 6 months old.

A physical exam may reveal signs of dehydration. The infant may have a swollen belly. The doctor may detect the abnormal pylorus, which feels like an olive-shaped mass, when touching the stomach area.

An ultrasound of the abdomen may be the first imaging test performed. Other tests that may be done include:

  • Barium x-ray -- reveals a swollen stomach and narrowed pylorus
  • Blood chemistry panel -- often reveals an electrolyte imbalance
Treatment

Treatment for pyloric stenosis involves surgery (called a pyloromyotomy) to split the overdeveloped muscles.

Balloon dilation does not work as well as surgery, but may be considered for infants when the risk of general anesthesia is high.

The patient will be given fluids through a vein, usually before surgery.

Expectations (prognosis)

Surgery usually provides complete relief of symptoms. The infant can usually tolerate small, frequent feedings several hours after surgery.

Complications
  • Vomiting after surgery -- this is very common and generally improves with time
  • Failure to gain weight in the newborn period
  • Risks associated with any surgery, which include:
    • Bleeding
    • Infection
Calling your health care provider

Call your health care provider if your baby has symptoms of this condition.

ReferencesWyllie R. Pyloric stenosis and congenital anomalies of the stomach. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds.Nelson Textbook of Pediatrics. 18th Ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 326.
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Related Questions

What is Pyloric stenosis also called?

Pyloric stenosis is also referred to as hypertrophic pyloric stenosis


How is pyloric stenosis treated?

pylorotomy


What is the narrowing of the opening between the stomach and intestines?

The Pyloric valve.


What does the medical abbreviation PS mean?

Pyloric Stenosis


Who is at risk for pyloric stenosis?

Male infants with a family history of pyloric stenosis are more at risk of having the condition, which tends to occur less often in females, blacks, and Asians.


How did Jon cryer get a scar?

Jon Cryer is a famous actor that has appeared in several movies and television shows. He got his scar from a pyloric stenosis surgery.


What is the narrowing of the opening between the stomach and the intestine?

Pyloric stenosis


Is vomiting a sign of pyloric stenosis?

Frequent vomiting may be an indication of pyloric stenosis and of other gastic complaints. In PS the vomiting will be violent (arch-like), not bile stained, and develop to become so persistent that the baby loses weight and condition. When this happens it is high time to see a doctor and if necessary insist on tests for PS.


What is the medical term meaning narrowing of the sphincter?

GastrostenosisMedical Terminology:Stomach: Gastronarrowing: StenosisYou may be referring to a condition that is common in this region known as Pyloric Stenosis; narrowing of the pylorus which is the opening to the stomach.


What is the medical term meaning narrowing of the pyloric sphincter?

Pylororrhaphy is the medical term meaning suture of the pyloric valve. A related term, pyloroplasty, means surgical repair of the pyloric valve.


What is cured by pyloromyotomy?

Pyloric stenosis can be cured with a surgical procedure called a pyloromyotomy


What is spider web with pyloric stenosis?

Has anyone heard of this link? I doubt it. Mebbee a joke?