Pyloric stenosis

Abstract Infantile hypertrophic pyloric stenosis is a common condition in infancy, characterized by an acquired muscular narrowing of the pylorus. Infants usually present in the first 2 months of life with projectile, non-bilious vomiting. A palpable ‘mass’ may be identified on careful examination of the abdomen, and sometimes a visible ‘peristaltic wave’ may be seen after a feed. The aetiology of pyloric stenosis remains largely unknown. Surgical intervention by pyloromyotomy is the standard treatment, although the operative approach varies. Careful resuscitation is essential to correct the metabolic disturbance caused by vomiting before surgery is undertaken.