Congenital Hypertrophic Pyloric Stenosis

What is Congenital Hypertrophic Pyloric Stenosis?

This is an important cause of vomiting, but it occurs in infants, usually in the two-week to two-month age bracket. The essential lesion is overdevelopment of the pyloric valve, so producing an effective obstruction to food passing from the stomach into the duodenum. It has nothing to do with ulcerations as with the adult problem.

Congenital Hypertrophic Pyloric Stenosis Symptoms

The baby is usually a normal, healthy, full-term infant, showing no abnormality. Often the infant commences to vomit intermittently when aged about three weeks. Frequently this results in the nature of the feed being altered. But this seldom brings improvement and, soon after, the baby is vomiting forcefully almost immediately after feeds. Toward the end of a feed, the baby appears to be restless and then will suddenly vomit violently, the material being forcibly ejected. After this the infant will contentedly settle back and avidly take a feed once more. Milk curds (rarely bile) are the only component of the vomits, but it may contain some of the previous day’s feed. Occasionally, due to irritation of the stomach walls, it may also contain blood.

Other important features are that the baby fails to thrive, usually loses weight and becomes constipated. Stools are small, hard and dehydrated.

Doctors may be able to feel a “tumor” that represents the enlarged valve in the pyloric region. Endoscopic or X-ray examination of the stomach usually confirms the diagnosis, together with the type of history suggested.

Congenital Hypertrophic Pyloric Stenosis Treatment

Unless treatment is carried out promptly, the outlook for the baby deprived of total nutrition is poor, and death will most likely occur within a few weeks.

Treatment is always surgical, and the results are curative and dramatic.