Pediatrics, Pyloric Stenosis Follow-up
- Author: Jagvir Singh, MD; Chief Editor: Richard G Bachur, MD more...
Further Inpatient Care
The infant with pyloric stenosis should continue to receive intravenous fluid until feeding is resumed. Feeding can be initiated 4-8 hours after recovery from anesthesia, although earlier feeding has been studied. Infants who are fed earlier than 4 hours do not have a worse total clinical outcome; however, they do vomit more frequently and more severely, leading to significant discomfort for the patient and anxiety for the parents.
- As many as 80% of patients continue to regurgitate after surgery; however, patients who continue to vomit 5 days after surgery may warrant further radiologic investigation.
- Patients should be observed for surgical complications (eg, incomplete pyloromyotomy, mucosal perforation, bleeding) and may be discharged home when adequately hydrated and tolerating feedings well.
- A study from the Children's Hospital of Philadelphia showed that infants fed ad libitum were able to tolerate full feedings sooner after laparoscopic pyloromyotomy, and the standardized feeding regimen had no advantage over ad libitum feedings.[10]
Prognosis
- Surgery is curative with minimal mortality.
- The prognosis is very good, with complete recovery and catch-up growth if detected in a timely fashion.
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