STOMACH OUTFLOW OBSTRUCTION- PYLORIC STENOSIS

• The last part of the stomach is known as pylorus. This outlet from stomach continues as the intestines.

• Sometimes the outlet gets narrowed and then blocked because of thickening of muscles around the outlet.

•  As the food cannot pass forward, the baby starts repeatedly vomiting. This obstruction is a progressive disease, that means the symptoms can get worse with time.

CAUSES

The exact cause of this obstruction is not known. There are some suggestive findings

• More chances of baby suffering from one if parents had them as babies

• Relation to intake of certain antibiotics during pregnancy

• Seen more commonly in certain syndromes

SYMPTOMS

Vomiting-

• Increased frequency and quantity over time. Maybe forceful.

• It appears as milky or semi-digested milk vomits and it’s never Green in colour.

• Starts at around 1 month of age. can present earlier or later even.

• Vomiting can be a sign of reflux or serious infections or abdominal emergencies. The differentiating feature is that the child with pyloric stenosis generally is a hungry and active.

• If the vomiting is not attended to then signs of dehydration can occur

Mass in tummy-

• You could feel a mass just above baby’s umbilicus.

• After each feed, you may notice excess gurgling noise or see tumble rumble

• May have signs of dehydration( see dehydration section)

INVESTIGATIONS-

• Ultrasound of abdomen is done to see the mass

TREATMENT

• Any vomiting that concerns you has to be discussed with the doctor.

• After stabilising the sick child by starting Intravenous fluids, a tube is passed from nose to stomach to clear contents. the tube is regularly aspirated to keep the stomach empty

• Surgery- the obstruction is released and feeding reintroduced.

DANGER SIGNS

• Green Colour vomits- means obstruction can be lower than stomach

• Signs of infection- changes in colour, behaviour, consciousness, Fits

• Dehydration signs, Lethargy

• Blood in stool or vomit