Pyloric stenosis natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
The [[gastric outlet obstruction]] due to the hypertrophic pylorus impairs emptying of gastric contents into the [[duodenum]] | The [[gastric outlet obstruction]] due to the hypertrophic pylorus impairs emptying of gastric contents into the [[duodenum]] that causes projectile vomiting. The vomited material does not contain [[bile]] because the pyloric obstruction prevents entry of duodenal contents (containing bile) into the [[stomach]]. | ||
[[Vomiting]] after surgery is the most common complication of infantile hypertrophic pyloric stenosis. Failure to gain weight in the newborn ,[[Bleeding]] and [[Infection]] after [[surgery]] are the other [[Complication (medicine)|complications]] of infantile pyloric stenosis. | [[Vomiting]] after surgery is the most common complication of infantile hypertrophic pyloric stenosis. Failure to gain weight in the newborn, [[Bleeding]] and [[Infection]] after [[surgery]] are the other [[Complication (medicine)|complications]] of infantile pyloric stenosis. | ||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
===Natural History=== | ===Natural History=== | ||
* The symptoms of pyloric stenosis usually develop in the first days of life, and start with projectile vomiting. | * The symptoms of pyloric stenosis usually develop in the first days of life, and start with projectile vomiting. | ||
* If left untreated, infants with mild infantile pyloric stenosis can develop significant problems on the cognitive, receptive language , fine motor , and gross motor skills subscales compared to the normal infants.<ref name="pmid21129547">{{cite journal| author=Walker K, Halliday R, Holland AJ, Karskens C, Badawi N| title=Early developmental outcome of infants with infantile hypertrophic pyloric stenosis. | journal=J Pediatr Surg | year= 2010 | volume= 45 | issue= 12 | pages= 2369-72 | pmid=21129547 | doi=10.1016/j.jpedsurg.2010.08.035 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21129547 }} </ref> | * If left untreated, infants with mild infantile pyloric stenosis can develop sever electrolyte imbalances include [[hypokalemia]] , [[hypochloremia]], and [[metabolic alkalosis]]. | ||
* In some cases of untreated pyloric stenosis, patients can develop significant problems on the cognitive, receptive language, fine motor, and gross motor skills subscales compared to the normal infants due to long term malnutrition.<ref name="pmid21129547">{{cite journal| author=Walker K, Halliday R, Holland AJ, Karskens C, Badawi N| title=Early developmental outcome of infants with infantile hypertrophic pyloric stenosis. | journal=J Pediatr Surg | year= 2010 | volume= 45 | issue= 12 | pages= 2369-72 | pmid=21129547 | doi=10.1016/j.jpedsurg.2010.08.035 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21129547 }} </ref> | |||
===Complications=== | ===Complications=== | ||
complications of infantile pyloric stenosis include: | complications of infantile pyloric stenosis include: | ||
* [[Vomiting]] after [[surgery]]. this is very common and generally improves with time. | * [[Vomiting]] after [[surgery]]. this is very common and generally improves with time. | ||
* Failure to gain weight in the [[newborn]] period | * Failure to gain weight in the [[newborn]] period | ||
* | * Common complications of the [[surgery]] are : | ||
** [[Bleeding]] | ** [[Bleeding]] | ||
** [[Infection]] | ** [[Infection]] | ||
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===Prognosis=== | ===Prognosis=== | ||
* [[Surgery]] usually provides complete relief of symptoms. The [[infant]] can usually tolerate small, frequent feedings several hours after [[surgery]]. | * Prognosis is generally excellent and [[Surgery]] usually provides complete relief of symptoms. The [[infant]] can usually tolerate small, frequent feedings several hours after [[surgery]]. | ||
* As many as 80% of patients continue to regurgitate after [[surgery]]. | * As many as 80% of patients continue to regurgitate after [[surgery]]. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]
Overview
The gastric outlet obstruction due to the hypertrophic pylorus impairs emptying of gastric contents into the duodenum that causes projectile vomiting. The vomited material does not contain bile because the pyloric obstruction prevents entry of duodenal contents (containing bile) into the stomach.
Vomiting after surgery is the most common complication of infantile hypertrophic pyloric stenosis. Failure to gain weight in the newborn, Bleeding and Infection after surgery are the other complications of infantile pyloric stenosis.
Natural History, Complications, and Prognosis
Natural History
- The symptoms of pyloric stenosis usually develop in the first days of life, and start with projectile vomiting.
- If left untreated, infants with mild infantile pyloric stenosis can develop sever electrolyte imbalances include hypokalemia , hypochloremia, and metabolic alkalosis.
- In some cases of untreated pyloric stenosis, patients can develop significant problems on the cognitive, receptive language, fine motor, and gross motor skills subscales compared to the normal infants due to long term malnutrition.[1]
Complications
complications of infantile pyloric stenosis include:
- Vomiting after surgery. this is very common and generally improves with time.
- Failure to gain weight in the newborn period
- Common complications of the surgery are :
Prognosis
- Prognosis is generally excellent and Surgery usually provides complete relief of symptoms. The infant can usually tolerate small, frequent feedings several hours after surgery.
- As many as 80% of patients continue to regurgitate after surgery.
- Patients who continue to vomit 5 days after surgery may warrant further radiologic investigation.
References
- ↑ Walker K, Halliday R, Holland AJ, Karskens C, Badawi N (2010). "Early developmental outcome of infants with infantile hypertrophic pyloric stenosis". J Pediatr Surg. 45 (12): 2369–72. doi:10.1016/j.jpedsurg.2010.08.035. PMID 21129547.