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Paediatric pyloric stenosis

OVERVIEW

Paediatric pyloric stenosis is a medical condition that occurs in infants and results in the narrowing of the pylorus, which is the passage between the stomach and the small intestine. Paediatric pyloric stenosis is a medical condition that is marked by the narrowing of the opening between the stomach and small intestine, known as the pylorus. This narrowing leads to symptoms such as vomiting, weight loss, and dehydration. This condition usually affects male infants aged between 3 weeks and 3 months. Although the exact cause of the condition is uncertain, it is believed to be associated with genetics and other factors. Prompt medical attention is crucial to treat paediatric pyloric stenosis and prevent complications like malnutrition and electrolyte imbalances.

Signs and symptoms of pyloric stenosis

The signs and symptoms of paediatric pyloric stenosis typically develop gradually over time and may include the following:

Projectile vomiting: Forceful vomiting that shoots out of the mouth and can project several feet away.
Dehydration: causes reduced urination, dry mouth and lips, sunken eyes, and a decrease in wet diapers.
Weight loss: A significant decrease in weight or failure to gain weight.
Constant hunger: A strong desire to feed but difficulty keeping food down.
Irritability: Crying, fussiness, and general discomfort.
Visible peristalsis: Visible waves of contractions in the abdomen.
Palpable olive-shaped mass: A lump that can be felt in the abdomen, usually located in the upper right quadrant.

These symptoms typically worsen over time and may become more severe if left untreated. If your infant exhibits any of these symptoms, seek medical attention immediately.

Treatment

A common treatment for pyloric stenosis is a surgical procedure known as pyloromyotomy and can be performed as an open or laparoscopic procedure. This involves creating a small incision in the abdominal wall and cutting the muscle fibres of the pylorus to widen the opening between the stomach and small intestine. This allows food to pass through more easily and relieves the symptoms associated with the condition.

Before the surgery, the infant may need to receive intravenous (IV) fluids to correct any dehydration or electrolyte imbalances that may have occurred as a result of the vomiting. In some cases, a nasogastric tube may also be inserted to relieve pressure on the stomach.

The surgery is generally safe and has a high success rate. Most infants are able to resume feeding shortly after the procedure and typically recover quickly. However, as with any surgical procedure, there are some risks associated with a pyloromyotomy, and your doctor will discuss these with you before the procedure.

REQUEST A CONSULTATION

Dr Mangray, the founder of KZN Specialised Paediatric Surgical Service, and his associates, Dr Ngobese, Dr Govender and Dr Dube-Zvirikuzhe, have a well-established reputation for caring for children right until late adolescence.

FREQUENTLY ASKED QUESTIONS

FAQ

1What is the success rate of pyloromyotomy surgery?

The surgery has a high success rate, with most infants experiencing a significant improvement in symptoms.

2Can paediatric pyloric stenosis be prevented?

Currently, there is no known method to prevent the condition.

3Is it normal for infants to vomit?

It is normal for infants to spit up or vomit occasionally, but if it is forceful and persistent, it could be a sign of paediatric pyloric stenosis and should be evaluated by a doctor.