Pyloric stenosis physical examination
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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
Physical examination of patients with infantile pyloric stenosis is usually remarkable for palpation of an abdominal mass in epigastrium.This mass, which consists of the enlarged pylorus, is referred to as the olive. Hypothermia and tachycardia with regular pulse and tachypnea may be present. In skin examination cyanosis, poor skin turgur, jaundice and pallor may be present.
Physical Examination
The presence of palpation of an abdominal mass and visible peristalsis on physical examination is diagnostic of infantile pyloric stenosis.
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Vital Signs
- Hypothermia may be present[1]
- Tachycardia with regular pulse may be present due to dehydration
- Tachypnea may be present due to dehydration
Skin
- Cyanosis may be present due to dehydration
- Poor skin turgor may be present due to dehydration
- Jaundice may be present
HEENT
- Depressed fontanelles may be present due to dehydration
- Decereased tearing may be present due to dehydration
Neck
Physical examination of neck is usually normal.
Lungs
Physical examination of lungs is usually normal.
Heart
Physical examination of heart is usually normal.
Abdomen
- Palpation of the abdomen may reveal a mass in the epigastrium.
- This mass consists of the enlarged pylorus smooth muscle,is called olive.[2]
- Palpation of a hypertrophied pylorus is very useful in diagnosis of hypertrophic pyloric stenosis.[3]
- Peristaltic waves may be palpated or may be seen in abdominal exam of patients with infantile pyloric stenosis.[4]
Back
Physical examination of back is usually normal.
Genitourinary
Physical examination of genitourinary system is usually normal.
Neuromuscular
Physical examination of neuromuscular system is usually normal.
Extremities
Physical examination of extremities is usually normal.
References
- ↑ Yagupsky P, Mares AJ, Gorodischer R (1986). "Pyloric stenosis associated with hypothermia". J Trop Pediatr. 32 (5): 270. PMID 3795342.
- ↑ Peters B, Oomen MW, Bakx R, Benninga MA (2014). "Advances in infantile hypertrophic pyloric stenosis". Expert Rev Gastroenterol Hepatol. 8 (5): 533–41. doi:10.1586/17474124.2014.903799. PMID 24716658.
- ↑ Breaux CW, Georgeson KE, Royal SA, Curnow AJ (1988). "Changing patterns in the diagnosis of hypertrophic pyloric stenosis". Pediatrics. 81 (2): 213–7. PMID 3277156.
- ↑ Chiou JY, Huang SC, Chuang JH (1991). "[Clinical experience of infantile hypertrophic pyloric stenosis]". Changgeng Yi Xue Za Zhi. 14 (1): 39–43. PMID 2039969.