Pyloric Stenosis

Definition:
Pyloric Stenosis is one of the most common surgical disorders of early infancy. the circular muscle that lies at the bottom of the stomach is to large and greatly decreases the size (stenosis) of the tube (pylorus) that empties the stomach. It is discovered soon after birth due to frequent vomiting that worsens and can become "projectile" (forceful enough that it can travel 2-4 feet at times). It is more common in males and is more likely in a full-term infant than in a premature. The cause is unknown and it does seem to be hereditary.

The pattern of vomiting and the age when this occurs does vary. Generally, the baby is well for the first weeks of life, and then has some episodes of vomiting or an occasional projectile vomiting episode around the 2nd to the 4th week. Some babies may have symptoms at birth. Others may develop projectile vomiting and become dehydrated quickly. Vomiting usually occurs shortly after a feeding, or a few hours after. The infant is hungry and will usually accept a second feeding after a vomiting episode.

Tests:
Your doctor may order an X-ray or an ultrasound to help diagnose the stenosis. A blood draw will also tell if your baby is dehydrated from al the vomiting. Please fee free to ask your doctor what the tests mean. Your Pediatric nurse will prepare you for what is going to be done for baby and is always ready to answer any questions you might have.

If Your Child Needs Surgery
Pylormyotomy is the name of the surgery that relieves the obstruction. Your baby will most likely have an IV (intravenous) line started to help rehydrate her/him. Sometimes the doctor will hold off on the surgery until after the baby is rehydrated, but that depends on the situation.

You will be able to accompany your infant to just outside the surgery area doors and will be shown where you can wait. You may choose to stay in your baby's hospital room.

Your baby's incision will be small and may only have "steristrips" (tiny tapes) over the incision. Feedings might begin anywhere from right after your child returns to her/his hospital room to 4-6 hours after surgery. It is not uncommon for infants to vomit after surgery; therefore it is important to monitor your baby's progress. Small, frequent feedings of an electrolyte solution are started and increased in amounts and type of fluid as the baby tolerates the feedings. Feed your baby slowly and in a semi-upright position. Burp frequently. After feeding, place your baby on his right-side with a rolled blanket at his back (to keep him from turning over) or in an infant seat. This will help empty the stomach and prevent vomiting. Let your nurse know if your baby does vomit and how many stools and wet diapers your baby has. A handout on incision care is available. Be sure to ask your Pediatric nurse, we're here to help.