pyloric stenosis

Projectile vomiting + the 'olive' → refer surgeons
Etiology Hypertrophy of smooth muscle in pylorus. Onset 2-12 weeks of life.
Epidemiology Incidence: 1-5/1000, M>F 5:1. RF: FHx, prematurity.
Clinical presentation projectile non-bilous vomiting, weight loss
↓K, ↓Cl metab alkalosis (suggests symptoms over 3+ weeks); classically upper quadrant “olive-shaped” abdo mass, visible waves of peristalsis after feeds
Pathogenesis
Diagnostic investigations USS abdo
Management Acutely: correct fluid/electrolyte imbalances
Definitive: pyloromyotomy (Ramstedt’s procedure)