Pyloric Stenosis
A 6-week-old male infant presents to the paediatric clinic with a two-week history of progressively worsening vomiting. The mother describes the vomiting as forceful and projectile, occurring after most feedings. She notes that the baby is hungry immediately after vomiting and is eager to feed again, but the vomiting persists. The infant has had fewer wet diapers in the past few days and seems increasingly irritable.
Upon physical examination, the baby appears dehydrated with a sunken fontanelle and dry mucous membranes. Palpation of the abdomen reveals a small, firm, olive-shaped mass in the upper right quadrant. The infant's weight is below the growth curve for his age, indicating poor weight gain.
An abdominal ultrasound is ordered and confirms the diagnosis of hypertrophic pyloric stenosis, showing significant thickening of the pyloric muscle and narrowing of the pyloric canal.
The infant is admitted to the hospital for intravenous fluid resuscitation and is scheduled for a pyloromyotomy. Following surgery, the prognosis for a full recovery is excellent.
a). Gastroesophageal reflux disease (GERD)
b). Intestinal malrotation
c). Hypertrophic pyloric stenosis
d). Congenital diaphragmatic hernia
a). Bloody stools
b). Failure to thrive with non-bilious projectile vomiting
c). Persistent diarrhea
d). Bilious vomiting
a). Immediate surgical repair without any preoperative preparation
b). Initiation of antibiotics
c). Intravenous fluid resuscitation to correct dehydration and electrolyte imbalance
d). Nasogastric tube insertion and wait for spontaneous improvement
a). Abdominal X-ray
b). Upper GI endoscopy
c). Abdominal ultrasound
d). Barium enema
