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Pediatric Pyloric Stenosis

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Summary

The pylorus is the opening between the stomach and the small intestine. Sometimes, the opening narrows or gets thicker, causing pyloric stenosis. When a baby has pyloric stenosis, food doesn't make it past the stomach into the intestines.

Babies usually develop problems from pyloric stenosis before they are six months old. Boys are more likely to have pyloric stenosis than girls, and genetics probably play a role in the disease, but no one knows exactly what causes it.

When a baby eats but cannot digest the food past the stomach, the baby vomits. Because the baby cannot absorb the food he stays hungry and wants more food. When the baby eats again, the vomiting is repeated. Sometimes it becomes very forceful (projectile vomiting).

Treatment

It is important to repair the pylorus before complications occur, such as severe constipation or even shock. Before surgery, doctors and surgeons treat the baby with medications and fluids to ensure the baby is healthy and ready for the procedure.

Surgery

  • Usually, surgeons perform a pyloromyotomy, which is a procedure that widens the pylorus.
  • If the baby is not healthy enough to have general anesthesia, surgeons can insert a small balloon attached to an endoscope (a small tube) down the food pipe into the narrowed pylorus, and then inflate the balloon to dilate or widen the opening of the pylorus. The baby can be awake during this procedure.

Both types of procedures are safe and highly effective.

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