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Let's imagine a swollen balloon, and our fingers covering the air outlet hole. Something like that, but in the stomach, is the effect that occurs in hypertrophic pyloric stenosis (HPS).
In this entity, the pylorus, which is the most distal area of the stomach, thickens and lengthens; in this way, the emptying of the digested food into the intestine is prevented through a 'clogging' effect.
The triggering cause is unknown, although the involvement of a series of risk factors has been described: administration of prostaglandins (this is a drug used in the management of some congenital heart diseases), early consumption of erythromycin (antibiotic from the group of macrolides), presence of family history and maternal smoking.
This entity makes its clinical debut at 2-6 weeks of life, and not before. Its main symptom is repeated vomiting. The vomiting of these patients is food content (never bilious). They are emitted with force ('shotgun'), immediately after all takes. The baby is very irritable and hungry. As the hours go by, the norm is that dehydration and electrolyte disturbances appear.
The diagnosis, as in many problems that affect the digestive system in children, is confirmed thanks to an abdominal ultrasound. In it we can see an increase in the thickness of the pyloric muscle and an elongation of the terminal part of the stomach.
The treatment is carried out in two phases. First, dehydration must be corrected by administering intravenous serum. After correcting this, the patient has to undergo surgery (called a pylorotomy), which can be done 'open-air', or laparoscopically. Its main sequel is the appearance of gastroesophageal reflux.
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