Wed3November0840PM 4

Are the following true or false of pyloric stenosis?

True / False

It is a surgical emergency Correct

The disease is more common in males Correct

Infants are often lethargic and unwilling to feed Incorrect answer selected

It usually presents in the first few days of life Correct

The characteristic metabolic abnormality is a metabolic alkalosis Correct

Explanation

Pyloric stenosis is most commonly diagnosed in children between the ages of 3 and 5 weeks. It affects approximately 1 in 250 infants and is commoner in males (4-6:1). Presentation is typically with (projectile) vomiting, failure to thrive and dehydration. It classically produces a hypochloraemic, hypokalaemic metabolic alkalosis. Children are classically hungry and keen to feed.

Pyloric stenosis is not a surgical emergency, rather a medical one. Children must be adequately resuscitated with an elective procedure performed once adequate biochemical parameters have been met. Typically this involves resolution of the alkalosis, adequate potassium and volume replacement. Where these are not performed, there is a risk of haemodynamic collapse and postoperative apnoea.