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

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

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

Images

Pyloric stenosis

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Pyloric stenosis Treatment

Review Date: 08/02/2009
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)