Davis AT Collection. Davis PT Collection. Murtagh Collection. About Search. Enable Autosuggest. You have successfully created a MyAccess Profile for alertsuccessName. Home Books Quick Answers Surgery. Previous Chapter. Next Chapter. In: Doherty GM.
Accessed Oct. Olive AP, et al. Infantile hypertrophic pyloric stenosis. Jobson M, et al. Contemporary management of pyloric stenosis. Seminars in Pediatric Surgery. Hypertrophic pyloric stenosis. Merck Manual Professional Version. Suspected pyloric stenosis pediatric. Mayo Clinic; The first form of treatment for pyloric stenosis is to identify and correct any changes in body chemistry using blood tests and intravenous fluids. Pyloric stenosis is always treated with surgery, which almost always cures the condition permanently.
The operation, called a pyloromyotomy, divides the thickened outer muscle, while leaving the internal layers of the pylorus intact. This opens a wider channel to allow the contents of the stomach to pass more easily into the intestines. A minimally invasive approach to abdominal surgery, called laparoscopy is generally the first choice of surgery for pyloric stenosis. To perform laparoscopic surgery, the surgeon inserts a rigid tube called a trocar into the abdominal cavity through a small incision cut.
The tube allows the surgeon to place a small camera into the abdomen and observe the structures within on an external monitor.
The abdomen is inflated with carbon dioxide gas, which creates room to view the contents of the abdomen and to perform the operation. Additional rigid tubes are placed through small incisions and used to insert small surgical instruments into the abdomen. These instruments are used together with the camera to perform the operation. Tubes and instruments are removed when the operation is finished and the incisions are closed with sutures stitches that are absorbed by the body over time.
Laparoscopic pyloromyotomy generally involves the use of two or three trocars, and therefore usually requires two or three small incisions. If the surgeon decides that a laparoscopic operation is not the best way to treat the problems that are found in the operating room, then the operation will be changed converted to use an older surgical technique. A diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs.
Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels. A diagnostic test that examines the organs of the upper part of the digestive system: the esophagus, stomach, and duodenum the first section of the small intestine. A fluid called barium a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an X-ray is swallowed.
X-rays are then taken to evaluate the digestive organs. Pyloric stenosis must be repaired with an operation. However, doctors may need to treat your baby's dehydration and mineral imbalances first. Water and minerals can be replaced through intravenous IV fluid.
Once your baby is no longer dehydrated, surgery can be performed. Under anesthesia, a small incision is made above the navel and the tight pyloric muscle is repaired. Babies can often begin drinking small amounts of clear liquids in the first 24 hours. Generally, clear liquids, such as an electrolyte drink, will be given to your baby first. However, babies may still vomit for several days after surgery due to swelling of the surgical site of the pyloric muscle.
The swelling goes away within a few days. Most babies will be taking their normal feedings by the time they go home. Babies are usually able to go home within two to three days after the operation.
This problem is unlikely to reoccur.
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