Aira Hospital

Pyloric stenosis is a congenital hypertrophy of the muscles in the pylorus. In plain words the muscle which regulates the outflow from the stomach into the duodenum is so voluminous and powerful that it blocks the gastric emptying. The child is sucking eagerly from the breast, but vomits all.

The diagnosis is usually made on the typical history of projectile (explosive) vomiting, and the typical hungry look in an underweight but eagerly sucking child.

Projectile vomiting	”Hungry look”     “Old man’s face”

 

Sometimes the hypertrophied pylorus muscle can be palpated (manually felt) through the abdominal wall. Ultrasound scanning can often confirm the diagnosis by illustrating the dilated stomach and the hypertrophied muscle.

Ultrasound scanning picture of pyloric stenosis. Dilated stomach and “pseudotumor” representing hypertrophied pyloric muscle with echo shadow.

 

The surgical treatment is extremely simple and outmost rewarding. It can even be done in local anesthesia if the child is very malnourished and critical. The hypertrophied muscle is simply split to allow the inner part of the stomach wall to expand, opening up for the passage of stomach content – breast milk. It can be done as daycare surgery. The surgical fee is 300 birr.

 

Hypertrophied pyloric muscle	Cutting the hypertrophic pyloric muscle
Splitting the hypertrophic pyloric muscle	Splitting the hypertrophic pyloric muscle