Pyloric stenosis natural history, complications and prognosis
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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. As a consequence, all ingested food and gastric secretions can only exit via vomiting, which can be of a projectile nature. 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 significant problems on the cognitive, receptive language , fine motor , and gross motor skills subscales compared to the normal infants.[1]
Associated Conditions
About 7% of babies will have other conditions such as intestinal malrotation, urinary tract obstruction, and esophageal atresia.
Complications
- Vomiting after surgery -- this is very common and generally improves with time
- Failure to gain weight in the newborn period
- Risks associated with any surgery, which include:
Prognosis
- 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.