Hypertrophic pyloric stenosis

Abstract

A 6-week old baby was brought to A&E by her parents, after a 3 week history of frequent vomiting, not tolerating feeds, and weight loss. She was well for the first 3 weeks of life, before she stopped tolerating any feeds. Despite several changes with the feeds given, the baby鈥檚 symptoms did not improve. Moreover, she started losing weight, while she became increasingly irritable and inconsolable. Her consultant paediatrician decided to admit her for a trial of other formula feeds, and further investigations. In hospital, examination was unremarkable, except for an intermittently palpable mass in the RUQ. An ultrasound of the abdomen confirmed the diagnosis of pyloric stenosis. She was kept nil by mouth, an NG tube inserted for drainage, and intravenous fluids administered, with close monitoring of fluid input and output. Pyloromyotomy was performed and the patient was discharged after ensuring that she was tolerating feeds.