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Pyloric Stenosis
- The cause of the hypertrophied pylorus muscle is unknown, but it is usually not present at birth. Mean onset of symptoms is 2-3 weeks of life, but range can be birth to 5 months with a 4:1 male to female occurrence.
- Clasic presentation is projectile, nonbilious vomiting of last feed which may be immediate or hours later.
- Pyloric Stenosis is the most common reason for abdominal surgery in the first 6 months of life.
- Textbook lab abnormality is a Hypochloremic hypokalemic metabolic alkalosis but this is a later finding and can not be used to rule out the diagnosis.
- Ultrasonography has become the standard imaging technique for diagnosis. It is reliable, highly sensitive, highly specific, and easily performed.
- Muscle wall thickness 3 mm or greater and pyloric channel length 14 mm or greater are considered abnormal in infants younger than 30 days.
- DDX includes : Normal Regurgitation (all babies do it!!!), GERD, Milk Intorerance, Obstruction (antral webs, volvulus,intussusception)