Wed3November0832PM 1

Which of the following is true of congenital pyloric stenosis?

(Please select 1 option)

Is often diagnosed by feeling a mass epigastric region to the right of midline Correct

Can cause hyperchloraemic alkalosis

Is inherited as an autosomal recessive

Presents approximately three months after birth

Typically presents with bile stained vomiting after feeds

Explanation

Hypertrophic pyloric stenosis occurs in approximately 3:1,000 live births. Males (especially first born) are affected approximately four times as often as females. Family clustering occurs.

Pyloric stenosis is associated with other congenital defects, including tracheo-oesophageal fistula.

The vomiting usually starts after three weeks of age, but symptoms may develop as early as the first week of life, and as late as the fifth month.

Non-bilious vomiting is the initial symptom, which progressively becomes more vigorous. As vomiting continues, there is a progressive loss of fluid, hydrogen ion, and chloride, leading to a hypochloraemic metabolic alkalosis.

The diagnosis is established by palpating the pyloric mass. The mass is firm, movable, approximately 2 cm in length, olive shaped, hard, best palpated from the left side, and located above and to the right of the umbilicus in the mid-epigastrium beneath the liver edge.

Imaging procedures (USS or barium meal) are reserved for those infants in whom the diagnosis remains in doubt.

Answer Statistics

1

50%

2

14%

3

12%

4

15%

5

11%

Times answered: 251