Pyloric Stenosis Treatment In a Paediatric CEPOD Introduction Pyloric Stenosis is a hypertrophic condition where increased thickening of the pylorus muscle leads to an obstruction between the stomach and the jejunum. It normally presents between two and seven weeks of age and is four times more likely to occur in boys (1). The pathophysiology of the condition is unknown although it’s more likely to happen in those with a family history, especially on the maternal side. The usual presentation is a large amount of vomiting that eventually becomes projectile. If not identified soon the child will soon become dehydrated and less likely to attempt feeding. Weight loss can also occur. The diagnosis is usually made by clinical history, palpation of an olive like mass in the upper right quadrant, usually backed up with ultrasound. The patient’s arterial blood gas can also sometimes show a hyperchloremic acidosis due to the evacuation of stomach contents. …show more content…
He was brought in to Kingston accident and emergency on Friday a Friday evening after four days of increasing vomiting that had become projectile. The child had lost one hundred grams of weight and had a palpable “olive” like mass in the right upper quadrant. The child had already had a small procedure for a tongue-tie but otherwise had no other medical issues and no known allergies. He was born via caesarean section at forty-one weeks plus four. Investigations were performed and the infant had an arterial blood gas, abdominal x-ray and abdominal ultrasound. The arterial blood gasses showed a slight acidosis but the chlorine and potassium were normal. The x-ray showed no gas in the bowel and the ultrasound showed a thickening of the pyloric muscle. The diagnosis of pyloric stenosis was made and the treatment plan was made. The child was admitted to hospital with a small bolus of fluids and maintenance fluids in the form of saline and