Pyloric stenosis natural history, complications and prognosis: Difference between revisions
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===Prognosis=== | ===Prognosis=== | ||
* Prognosis is generally excellent and [[Surgery]] usually provides complete relief of symptoms. [[infant]]<nowiki/>s usually tolerate small, frequent feedings several hours after [[surgery]]. | * Prognosis is generally excellent and [[Surgery]] usually provides complete relief of symptoms. [[infant]]<nowiki/>s usually tolerate small, frequent feedings several hours after [[surgery]].<ref name="pmid1127996">{{cite journal| author=Gibbs MK, Van Herrden JA, Lynn HB| title=Congenital hypertrophic pyloric stenosis. Surgical experience. | journal=Mayo Clin Proc | year= 1975 | volume= 50 | issue= 6 | pages= 312-6 | pmid=1127996 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1127996 }} </ref> | ||
* As many as 80% of patients continue to regurgitate after [[surgery]]. | * As many as 80% of patients continue to regurgitate after [[surgery]].<ref name="pmid1127996">{{cite journal| author=Gibbs MK, Van Herrden JA, Lynn HB| title=Congenital hypertrophic pyloric stenosis. Surgical experience. | journal=Mayo Clin Proc | year= 1975 | volume= 50 | issue= 6 | pages= 312-6 | pmid=1127996 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1127996 }} </ref> | ||
* Patients who continue to vomit 5 days after [[surgery]] may warrant further investigation. | * Patients who continue to vomit 5 days after [[surgery]] may warrant further investigation. | ||
==References== | ==References== | ||
{{Reflist|2}}{{WH}} {{WS}} | {{Reflist|2}}{{WH}} {{WS}} | ||
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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 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.[1]
- In rare cases of untreated pyloric stenosis, patients may 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.[2]
Complications
Complications of infantile pyloric stenosis include:
- Vomiting after surgery. this is very common and generally improves over time.[3]
- Failure to gain weight in newborn period[4]
- Common complications of the surgery are :
Prognosis
- Prognosis is generally excellent and Surgery usually provides complete relief of symptoms. infants usually tolerate small, frequent feedings several hours after surgery.[6]
- Patients who continue to vomit 5 days after surgery may warrant further investigation.
References
- ↑ Tutay GJ, Capraro G, Spirko B, Garb J, Smithline H (2013). "Electrolyte profile of pediatric patients with hypertrophic pyloric stenosis". Pediatr Emerg Care. 29 (4): 465–8. doi:10.1097/PEC.0b013e31828a3006. PMID 23528507.
- ↑ 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.
- ↑ Spitz L (1979). "Vomiting after pyloromyotomy for infantile hypertrophic pyloric stenosis". Arch Dis Child. 54 (11): 886–9. PMC 1545582. PMID 526031.
- ↑ Srivastava NT, Parent JJ, Schamberger MS (2017). "Consideration of pyloric stenosis as a cause of feeding dysfunction in children with cyanotic heart disease". Ann Pediatr Cardiol. 10 (3): 298–300. doi:10.4103/apc.APC_51_17. PMC 5594945. PMID 28928620.
- ↑ Romano C, Oliva S, Martellossi S, Miele E, Arrigo S, Graziani MG; et al. (2017). "Pediatric gastrointestinal bleeding: Perspectives from the Italian Society of Pediatric Gastroenterology". World J Gastroenterol. 23 (8): 1328–1337. doi:10.3748/wjg.v23.i8.1328. PMC 5330817. PMID 28293079.
- ↑ 6.0 6.1 Gibbs MK, Van Herrden JA, Lynn HB (1975). "Congenital hypertrophic pyloric stenosis. Surgical experience". Mayo Clin Proc. 50 (6): 312–6. PMID 1127996.