A Case Report on Pyloric Stenosis in Infants
Bhushan M. Petkar
Smt.Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe) Wardha, Maharastra, India.
Khushbu Meshram *
Smt.Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe) Wardha, Maharastra, India.
Jaya Khandar
Smt.Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe) Wardha, Maharastra, India.
Pooja Kasturkar
Smt.Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe) Wardha, Maharastra, India.
Prerana Sakharwade
Smt.Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe) Wardha, Maharastra, India.
Vaishali Tembhare
Smt.Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe) Wardha, Maharastra, India.
Shital Sakharkar
Smt.Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (Meghe) Wardha, Maharastra, India.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Pyloric stenosis also known as pylorostenosis or specifically as infantile hypertrophic pyloric stenosis (IHPS) is the tapering (stenosis) of the opening from the stomach to the first part of the small intestine (duodenum). The term “pylorus” indicates “gate”. The thickened pylorus is feels as an olive shaped abnormal mass in the upper right hypochondriac and epigastrium region of the infant’s abdomen.
Clinical Findings: Frequent vomiting after feeding which is projectile,non-bilious, in nature. Continual hunger, dehydration, alterations in bowel movements, weight issues.
Diagnostic Evaluation: History collection (family history), physical examination (olive shaped mass) at epigastrium, hematological test (CBC), biochemistry test (KFT) (electrolyte imbalance). Ultrasonography (USG) abdomen:- thickened pylorus (<3mm), narrowed pyloric lumen, gastric content can not pass to duodenum, superior mesenteric artery and superior mesenteric vein located without altered position.
Therapeutic Interventions: Inj. Cefotaxim 1gm 1.4ml IV × BD (Antibiotics), Inj. Pantodex 40mg 2ml IV × OD (proton-pump-inhibitor), Inj. Temfix 100ml 50ml IV ×BD (antipyretic analgesic), IV Fluids.
Surgical Interventions: Fred-Ramstedt’s Pyloromyotomy.
Outcome: After treatment, infant show improvement. His frequent vomiting has been stopped and hunger problem resolved, baby starts gaining weight after surgery.
Conclusion: My patient was 1 month 10 days old when he was admitted to the paediatric intensive care unit (ICU) with the chief complaint of frequent vomiting, persistent hunger, weight loss, and dehydration. After a thorough physical examination and a variety of tests, he was diagnosed with infantile hypertrophic pyloric stenosis.
Keywords: Pylorostenosis, pyloromyotomy, projectile-vomiting, olive shaped mass, mesenteric artery/vein