Pyloric Stenosis

Pyloric Stenosis is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Postnatal hypertrophy and hyperplasia of the circular smooth muscle cell layer causing a thickened pylorus and antrum leading to progressive gastric outlet obstruction
  • Neuronal nitric oxide synthase (NOS-1) may be a genetic susceptibility locus.
  • Administration of erythromycin in infants during 1st 2 wk of life may increase risk of hypertrophic pyloric stenosis.
  • Jaundice due to transient glucuronyl transferase deficiency
  • Adult: Caused by peptic ulcer disease

Etiology

  • Most common cause of GI obstruction in infants; incidence 1/150 males, 1/750 females (average: 3/1,000 live births)
  • Males affected 5× more commonly than females; firstborn most common
  • Familial, 15%:
    • Child of affected parent has 7% incidence.
    • Recurrence risk in subsequent male children is 10%; 2% in females.

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