Lecture Notes: Pyloric Stenosis

Introduction

• Presenter: Tom from Zero to Finals
• Topic: Pyloric Stenosis
• Resources: Written notes available at zerodefinals.com and in the Zero to Finals Pediatrics book

What is Pyloric Stenosis?

• Pyloric Sphincter: A ring of smooth muscle forming the canal between the stomach and duodenum
• Hypertrophy: Thickening and narrowing of the pylorus is referred to as pyloric stenosis
• Effect: Prevents normal passage of food from the stomach to the duodenum
• Result: Leads to increasingly powerful stomach peristalsis, eventually causing projectile vomiting

Features of Pyloric Stenosis

• Presentation: Occurs typically in the first few weeks of life
• Symptoms:
  • Hungry but thin and pale baby
  • General failure to thrive
  • Projectile vomiting
• Physical Examination:
  • Visible powerful peristalsis in the stomach post feeding
  • Firm, round mass in the upper abdomen that feels like a large olive (hypertrophic pylorus)

Diagnosis

• Blood Gas Analysis:
  • Hypochloremic (low chloride) metabolic alkalosis due to vomiting of hydrochloric acid
  • Important for exams
• Ultrasound: Used to visualize the thickened pylorus

Management

• Surgical Treatment:
  • Procedure: Laparoscopic pyloromyotomy (Ramstedt's operation)
  • Process: Incision in the pylorus smooth muscle to widen canal
  • Outcome: Allows normal food passage from stomach to duodenum
• Prognosis: Excellent post-operation

Additional Resources

• Zero to Finals Website: Notes, illustrations, questions
• Instagram and Personal Channel: Daily questions, learning tips
• Books and Flash Cards: Available for further study

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Note: The lecture content also emphasizes engaging with multiple resources, including video content and additional educational materials provided by Zero to Finals.