0 Frequency: 0.1-0.4%. It is 15 times more common in those with a family history.
0 More than 50% of patients are the first child. It is 4 times more common in males.
Clinic and Diagnosis
• 3-6 of your life. Non-bilious Projectile vomiting is typical.
• The baby is always hungry, so he cries constantly and sucks the bottle hungrily while feeding.
• There may be hematemesis due to esophagitis.
• Subcutaneous adipose tissue decreased in patients due to nutritional deficiency.
• Mucous membranes due to dehydration are dry and skin turgor-tonus is decreased, constipation occurs, urine is decreased and dark.
• Severe hypoglycemia may occur because the liver stores are empty.
• Indirect bilirubin may increase due to low glucuronyl transferase activity in patients.
• Metabolic alkalosis due to vomiting occurs (hypokalemic, hypochloremic alkalosis).
• Palpation of "olive" on physical examination is pathognomonic.
• Other physical examination findings are increased gastric peristalsis and decreased skin turgor-ton.
• In Standing direct abdominal radiographs, there is a single and large gastric gas chamber, "bugi bugi" or "caterpillar" appearance due to contractions in the greater curvature.
• Diagnosis can be made by ultrasonography (bull's eye, doughnut, target sign).
• Radiogram with opaque material shows "railway" or "rope sign".
• Pyloric atresia, duplications, duodenal atresia, hiatal hernias, gastroenteritis.
• Rectal biopsy may be required for the differential diagnosis of Hirschsprung in the case of an episode of intestinal obstruction in the neonatal period.
Treatment
• First, the fluid-electrolyte imbalance is corrected.
• Fredet-Ramstedt pyloromyotomy is performed.