Tuesday, November 18, 2003

The Washington Post has a story today describing one parent's journey through the diagnosis of pyloric stenosis. The child described in the story had experienced several weeks of vomiting that did not respond to changes in formula, which evolved to projectile vomiting when the child was seven weeks old. The child was diagnosed, underwent his operation (a Ramstedt pyloromyotomy) and got all better.
A pyloromyotomy is one of my favorite operations as it is usually done on otherwise healthy infants and the improvement is almost immediate. My most interesting case was a pyloric stenosis in a patient with situs inversus, so the incision was on the left side. That child presented with much the same story as the infant in the story, with a language barrier as well (the parents spoke only spanish). This child was suffering from severe failure to thrive, and required two weeks of TPN, in addition to full PO intake to maintain a stable weight.
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