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due Oct 7, 2018
Week 5: Discussion Part Two
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75 replies.
A three-month-old baby boy comes into your clinic with the main complaint that he frequently vomits
after eating. He often has a swollen upper belly after feeding and acts fussy all the time. According to
his parents, the vomiting has become more frequent this past week and he is beginning to lose
weight. After careful history taking, a thorough physical exam and diagnostic work-up, the patient is
diagnosed with pyloric stenosis.
1.
What is the etiology of pyloric stenosis?
2.
Describe in detail the pathophysiological process of pyloric
stenosis.
3.
Identify hallmark signs identified from the physical exam
and presenting symptoms. What diagnostic tests would
help to confirm the diagnosis of pyloric stenosis?
4.
Describe the pathophysiology of complications of pyloric
stenosis.
5.
What teaching would you provide this patient/parents
regarding pyloric stenosis?
In addition to the textbook, utilize at least one peer-reviewed, evidence based resource to
develop your post.
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Tiffani Pendleton
Tiffani Pendleton
Sep 30, 2018Sep 30, 2018 at 5:03pm
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Dr. Schwindenhammer and Classmates,
Etiology of Pyloric Stenosis
According to McCance and Huether (2014), pyloric
stenosis is a blockage of the pyloric sphincter due to
enlargement of the sphincter muscle. A common issue
for infants that affects more males than females. As with
this infant, it usually presents with vomiting right after
eating as the main symptom. According to McCance and
Huether (2014), the exact cause is unknown, but has
been attributed to increased gastrin secretion by the
mother during the final trimester of pregnancy,
administration of prostaglandin E, and even genetic
predisposition with family history.
Pathophysiological Process of Pyloric Stenosis
According to Ndongo, Tolefac, Tambo, Abanda, Ngowe,
Fola, Dzekem, Weledji, Sosso and Minkande (2018), the
enlargement and overproduction of the smooth muscle
cells of the pylorus causes narrowing and encroachment
by the pyloric sphincter muscle which makes it difficult for
adequate movement of food through the pylorus. With
the extra work being done to try and move the food
through the pylorus, it becomes even more enlarged
exacerbating the problem.
Hallmark Signs and Diagnostic Tests
The main sign of pyloric stenosis would be the sudden,
projectile vomiting after eating. According to McCance
and Huether (2014), along with the projectile vomiting
that usually starts around 2-3 weeks of age, the infant
usually wants to eat again immediately after vomiting and
constipation is always an issue because the food never
reaches the intestines as it should. If the infant continues
to vomit with feedings, then dehydration and electrolyte
issues are soon to follow as well. Since food never
actually reaches the intestines, these infants will have
infrequent stools and will likely be fussy and lethargic
from lack of intake. Although diagnosis is usually made
