The causes of pyloric stenosis are unknown, but genetic and environmental factors might play a role. Pyloric stenosis usually isn't present at birth and probably develops afterward.
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Pylorus The pylorus is a muscular valve that holds food in the stomach until it is ready for the next stage in the digestive process. Pyloric stenosis Open pop-up dialog box Close. Pyloric stenosis In pyloric stenosis, the pylorus muscles thicken, blocking food from entering the baby's small intestine.
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. An ultrasound of the abdomen may be the first imaging test performed. Other tests may include a barium X-ray to show the shape of the stomach and pylorus. 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.
All surgery carries a small risk of bleeding during or after the operation. There is a chance that the lining of the bowel could be damaged during the operation, but this is rare and will be stitched closed during the same operation.
Every anaesthetic carries a risk of complications but this is very small. The child will come back to the ward to recover. He or she will have been given pain relief during and after the operation.
For the first few hours, the child will continue to have fluids through the drip so that the stomach and bowel can start to heal. After six hours or so, we will start to feed the child, starting with small amounts, and increasing the amount as he or she tolerates it.
Your child may still have some vomiting but this will improve as the digestive system recovers from the operation. Your child will be able to go home once he or she is feeding well. The child will need to have regular pain relief such as paracetamol for at least three days so please make sure that you have some at home. The stitches used during the operation will dissolve on their own so there is no need to have them removed.
If possible, keep the operation site clean and dry for two to three days, to allow the operation site heal properly.
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