Pathophysiology of Pyloric Stenosis in Infants

This article discusses the clinical testing, diagnosis, causes, treatment and prevention of pyloric stenosis in infants. It also mentions the surgical procedures and preventive measures. The article cites references from various studies.

Running head: PATHOPHYSIOLOGY
PATHOPHYSIOLOGY
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1PATHOPHYSIOLOGY
Clinical testings
In reference to the case provided, the testing of the 2 months old baby will begin with
the physical examination. The physician tries to locate an olive-shaped lump in such cases
during examination of the baby’s abdomen. This is the enlarged pyloric muscle. The clinical
testing conducted for the child will include blood tests in order to check for occurrences of
dehydration or electrolyte imbalance. Ultrasound can be conducted for viewing the pylorus
and for confirming the diagnosis of pyloric stenosis, which may be the probable diagnosis. X-
ray can also be done of the baby’s digestive system, in case the ultrasound are not very clear
(Sivitz, Tejani and Cohen, 2013).
Diagnosis
The most probable diagnosis in such cases is the occurrence of pyloric stenosis. This
condition is detected by the affect is has on the gastrointestinal tract in the babies. This leads
to forceful vomiting and other conditions such as dehydration. The pylorus becomes narrower
in such conditions, which prevents the emptying of the food out in the stomach. Pyloric
stenosis is often known as infantile hypertrophic pyloric stenosis. This problems causes
gastric outlet obstruction that refers to blocks the stomach to the intestines (Eberly et al.,
2015).
Causes
Most of the times it is believed that the babies are not born with the condition of
pyloric stenosis. However they develop such condition gradually when there is thickening of
the pylorus after birth. When the pylorus is thick enough, the baby starts showing symptoms
since there is a problem in the emptying of the food into the stomach. Although the causes of
this thickening of the pylorus is not clear enough, it is believed that the causes presumably

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are the combination of various things. Use of antibiotic, specifically erythromycin during the
first 2 weeks after birth can be cause. Administration of antibiotic to the mother sat the end
stages of the pregnancy or breastfeeding can add up to the causes (Svenningsson et al., 2014).
Treatment
The infants who are diagnosed with pyloric stenosis, needs to be admitted to the
hospitals for treatment and generally made to undergo surgery. Problems of dehydration or
problems with the electrolytes in the blood are usually corrected with intravenous (IV) fluids
which is done within 24 hours.
Pyloromyotomy, which is a surgical procedure, is generally conducted which will
relief the blockage, by cutting the muscles of the pylorus that have got thickened. Through a
very small incision, the pylorus is examined. The overgrown muscles and the ones that are
thickened are spread and relaxed. Laparoscopy procedures can also be carried out for the
surgery. This technique places a tiny scope through an incision in the belly button which
allows the surgeon to get a proper view of the area of the pylorus. Although the baby may
still vomit in small amounts because of inflammation at the surgery site, most of the babies
get back to normal feedings more or less quickly within 3 to 4 hours after the surgery
(Lozada et al., 2013).
Prevention
Pyloric stenosis usually cannot be prevented. However avoiding erythromycin during
the final stages of pregnancy and early days of breastfeeding may act as preventive measures
in some cases.

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References
Eberly, M. D., Eide, M. B., Thompson, J. L., and Nylund, C. M. (2015). Azithromycin in
early infancy and pyloric stenosis. Pediatrics, 135(3), 483-488.
Lozada, L. E., Royall, M. J., Nylund, C. M., and Eberly, M. D. (2013). Development of
pyloric stenosis after a 4-day course of oral erythromycin. Pediatric emergency
care, 29(4), 498-499.
Sivitz, A. B., Tejani, C., and Cohen, S. G. (2013). Evaluation of hypertrophic pyloric stenosis
by pediatric emergency physician sonography. Academic Emergency Medicine, 20(7),
646-651.
Svenningsson, A., Svensson, T., Akre, O. and Nordenskjöld, A., (2014). Maternal and
pregnancy characteristics and risk of infantile hypertrophic pyloric stenosis. Journal
of pediatric surgery, 49(8), pp.1226-1231.