Pathophysiology of Pyloric Stenosis in Infants

Document Type:Coursework

Subject Area:Nursing

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Vomiting, usually forceful and projectile, happens right after eating and babies usually want to eat again after vomiting. Food retention is characteristic and can be seen 4 hours after eating unless the baby has vomited (McCance et al. These babies are usually constipated, which can be attributed to their fussiness. In advanced cases, severe fluid and electrolyte imbalances can occur as well as weight loss and irritability related to hunger and esophagitis (McCance et al. Distention around the antrum can occur, which decreases after vomiting. The hallmark sign of gastric outlet obstruction is non-bilious vomiting. Non-bilious vomit is vomit without bile. The vomiting occurs immediately after feeding and varies in intensity depending on the degree of stenosis present. With time vomiting becomes more severe and projectile.

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Another characteristic feature of pyloric stenosis is prolonged retention of food in the stomach and constipation. An elongated pyloric channel and streaks of barium flowing through the stenosed channel producing either a single, “string sign” or a “double track sign” is characteristic of Pyloric stenosis. Sometimes a barium swallow is done instead of an ultrasound; the baby swallows a small amount of a chalky liquid(barium), and then special X-rays are taken to view the pyloric area of the stomach to see if there any narrowing or blockage. The standard laboratory finding in pyloric stenosis is a hypochloremic (An abnormally low level of chloride ion in the blood due to electrolyte disturbances) and hypokalemic metabolic alkalosis. The doctor orders a blood test to check levels of electrolytes.

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