Pediatric Pyloric Stenosis Follow-up

Updated: Nov 13, 2018
  • Author: Sathyaseelan Subramaniam, MD, FAAP; Chief Editor: Kirsten A Bechtel, MD  more...
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Follow-up

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 a standardized feeding regimen had no advantage over ad libitum feedings. [21]
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Prognosis

See the list below:

  • Surgery is curative with minimal mortality. [22]
  • The prognosis is very good, with complete recovery and catch-up growth if detected in a timely fashion.
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Complications

In the patient that presents with vomiting and has a missed/delayed diagnosis of pyloric stenosis, there is risk of significant dehydration leading to hypovolemic shock.

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