Summary

  • Recurrent projectile nonbilious vomiting, typically in a 3- to-6-week-old infant (usually male), but may occur on older infants.
  • Features may include a history of feeding intolerance with multiple formula changes.
  • Failure to thrive/weight loss may progress to increasing volume depletion. An olive-shaped mass may be palpable in the right upper abdomen.
  • Ultrasound shows pyloric channel length >17 mm and pyloric muscle thickness >4 mm.
  • Treatment is with intravenous fluid and electrolyte replacement, followed by pyloromyotomy (open or laparascopic).
  • Complications of treatment surgery include wound infection, gastric or duodenal mucosal perforation, or incomplete myotomy.

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