What is hypertrophic pyloric stenosis in infants?
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Congenital hypertrophic pyloric stenosis; Infantile hypertrophic pyloric stenosis; Gastric outlet obstruction; Vomiting - pyloric stenosis Pyloric stenosis is a narrowing of the opening from the stomach into the small intestine. This is called the pylorus. This article describes the condition in infants. The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted. A narrowing of the outlet from the stomach to the small intestine (called the pylorus) that occurs in infants. The stomach connects the esophagus to the small intestines The pylorus of the stomach is a small, narrow muscular sphincter through which food passes into the duodenum after it has been partially digested in the stomach. CausesNormally, food passes easily from the stomach into the first part of the small intestine through a valve called the pylorus. With pyloric stenosis, the muscles of the pylorus are thickened. This prevents the stomach from emptying into the small intestine. The exact cause of the thickening is unknown. Genes may play a role, since children of parents who had pyloric stenosis are more likely to have this condition. Other risk factors include:
Pyloric stenosis occurs most often in infants younger than 6 months. It is more common in boys than in girls. SymptomsVomiting is the first symptom in most children:
Other symptoms appear several weeks after birth and may include:
Exams and TestsThe condition is often diagnosed before the baby is 6 months old. A physical exam may reveal:
Ultrasound of the abdomen may be the first imaging test. Other tests may include:
TreatmentTreatment for pyloric stenosis involves surgery to widen the pylorus. The surgery is called pyloromyotomy. If it is not safe to put the infant to sleep for surgery, an endoscope is used. This is a long, flexible tube with a camera and a tiny balloon at the end. The balloon is inflated to widen the pylorus. In infants who cannot have surgery, tube feeding or medicine to relax the pylorus is tried. Outlook (Prognosis)Surgery usually relieves all symptoms. As soon as several hours after surgery, the infant can start small, frequent feedings. Possible ComplicationsIf pyloric stenosis isn't treated, a baby won't get enough nutrition and fluid. The child can become underweight and dehydrated. When to Contact a Medical ProfessionalContact your health care provider if your baby has symptoms of this condition. ReferencesKliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Pyloric stenosis and other congenital anomalies of the stomach. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 355. Seifarth FG, Soldes OS. Congenital anomalies and surgical disorders of the stomach. In: Wyllie R, Hyams JS, Kay M, eds. Pediatric Gastrointestinal and Liver Disease. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 25. Version InfoLast reviewed on: 8/10/2021 Reviewed by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. What are the symptoms of pyloric stenosis in babies?Infants with pyloric stenosis may eat well but have these symptoms:. Frequent projectile vomiting (forceful vomiting), usually within a half hour to an hour after eating.. Abdominal (belly) pain.. Dehydration.. Hunger after feedings.. Irritability.. Small stools.. What is the most common early symptom of pyloric stenosis?The most common symptoms noted in a baby with pyloric stenosis is forceful, projectile vomiting. This kind of vomiting is different from a "wet burp" that a baby may have at the end of a feeding. Large amounts of breast milk or formula are vomited, and may go several feet across a room.
Can a baby grow out of pyloric stenosis?Long-term outlook. Pyloric stenosis is unlikely to reoccur. Babies who have undergone surgery for pyloric stenosis should have no long-term effects from it.
How is infant pyloric stenosis treated?Surgery is needed to treat pyloric stenosis. The procedure (pyloromyotomy) is often scheduled on the same day as the diagnosis. If your baby is dehydrated or has an electrolyte imbalance, he or she will have fluid replacement before surgery.
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