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.
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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.
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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.
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A study from the Children's Hospital of Philadelphia showed that a standardized feeding regimen had no advantage over ad libitum feedings. [21]
Next:
Prognosis
See the list below:
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Surgery is curative with minimal mortality. [22]
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The prognosis is very good, with complete recovery and catch-up growth if detected in a timely fashion.
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Next:
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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Media Gallery
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Point-of-care ultrasound performed by a pediatric emergency physician accurately identifying the pyloric wall thickness and length that meets criteria for pyloric stenosis diagnosis.
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The ‘antral nipple sign’ demonstrated by the arrow, the ‘X’ indicates the ‘shoulder sign’
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The ‘donut’ sign demonstrated by the arrow.
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Lateral view from an upper GI study demonstrates the double-track sign.
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