Congenital Pyloric Stenosis Symptoms and Treatment

Congenital Pyloric StenosisPylorus is a short muscular tube (20 mm long) with a normal inner diameter of approximately 5 mm. It connects the stomach with the duodenum, the first part of the intestine. In pyloric stenosis (the cause of this is unknown) the wall is thickened and the passage to the pylorus is narrowed. Because of this, milk passes from the stomach into the intestine in small ammounts or does not pass at all, and the baby can not absorb nutrients from the milk.

Symptoms

Two to eight weeks after birth, the baby begins to vomit after eating. Strong stomach contractions fail to squeeze the food through the stomach, so they return it to the esophagus and into the mouth. The vomit usually contains a lot of milk and mucus and has an unpleasant smell. Initially, vomiting does not affect on the child’s health or desire for food. However, the baby begins to lose weight soon, becomes restless, and the stools are smaller and less frequent.
If a child is not treated, he usually eats lazily and becomes sluggish. This is partly because the constant vomiting disturbs the sensitive balance of the chemical substances in the child’s body.

Frequency

Approximately one in 150 male and one in 775 female newborns has this disorder. It occurs more often in the firstborn and is usually inherited. The disorder also often occurs with identical twins.

Dangers

In severe cases, if the disorder is not treated, death may occur due to dehydration and disturbed balance of chemical substances in body fluids.

What to do?

If your child is vomiting in a way we described, contact your doctor immediately. The doctor will examine the belly of the child, observe how the child eats, taking into account the strong abdominal contractions, which are characteristic for pyloric stenosis. Contractions are like a ping-pong ball that travels left to right beneath the skin surface. In some cases, more than one examination will be necessary (and, in rase cases, X-ray) to confirm the diagnosis. You may hear a doctor using a term pyloric tumor for this condition. But that is not the reason to to worry; the word ”tumor” is a common medical expression for every benign swelling.

Treatment

Self-help: until you get medical help, feed your baby more often than usual, but reduce the usual amount of meals.

Professional help: the problem is removed by a simple surgical procedure known as Ramstedt’s operation. The operation consists of a cut in the abdomen, and a deep cut along the outer side of the thickened pylorus. This allows the extension within the pylorus and the passage of the food. After the operation, the ammount of food that is given to a baby gradually increases, and after 48 hours the baby is already fed in the usual way. The success of the operation is almost 100%.