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Hypertrophic Pyloric Stenosis

Thickening of the pyloric muscle in infants leads to vomiting and feeding difficulty.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Çocuk Sağlığı ve Hastalıkları department. Book Appointment →

What is Hypertrophic Pyloric Stenosis?

Hypertrophic pyloric stenosis (HPS) is one of the most common indications for infant surgery. Its incidence is 1–4 per 1000 live births. It is 4–5 times more common in boys. Genetic and environmental factors play a role.

The pyloric muscle layer progressively thickens and lengthens, obstructing the gastric outlet. It classically begins between 2 and 8 weeks of age. Projectile vomiting, hunger after vomiting, and weight loss are typical.

Diagnosis is made by ultrasound: pyloric muscle thickness ≥4 mm, channel length ≥15 mm. The classic physical finding is an 'olive' mass. Treatment is by Ramstedt pyloromyotomy (laparoscopic or open).

Symptoms

Projectile vomiting of gastric contents
Hunger in the infant after vomiting
Failure to gain weight or weight loss
Signs of dehydration
Olive-shaped mass (right upper quadrant)
Visible peristalsis

Risk Factors

Male sex
Firstborn
Family history of HPS
Erythromycin use (prenatal/postnatal)
Formula feeding
Exposure to cigarette smoke

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Projectile vomiting in an infant aged 2–8 weeks
  • Failure to gain weight
  • Signs of dehydration
  • Hungry crying after feeds
  • Palpable mass in the right upper quadrant

Treatment Methods

01
First step: correction of electrolytes and dehydration
02
Treatment of hypochloremic, hypokalemic metabolic alkalosis
03
Surgery: Ramstedt pyloromyotomy (gold standard)
04
Laparoscopic approach is preferred today
05
Initiation of feeding within 24 hours postoperatively
06
Excellent prognosis and complete recovery

Which Department to Visit?

You can visit our Çocuk Sağlığı ve Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Çocuk Sağlığı ve Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.