Hello and welcome to the Zero to Finals podcast.

My name is Tom, and in this episode I'm going to be talking to you about Pyloric Stenosis.

And if you want to follow along with written notes on this topic,

you can follow along at zero tofinals.com slash pylorox stenosis,

or in the gastroenterology section of the zero definals pediatrics book.

So let's get straight into it. The pyloric sphincter is a ring of smooth muscle that forms the

canal between the stomach and the duodenum. Hyperdrophy, which is thickening and therefore

narrowing of the pyloris is called pyloric stenosis.

This prevents food travelling from the stomach to the duodenum as normal.

After feeding, there's increasingly powerful peristalysis in the stomach as the stomach tries to push food into the duodenum.

Eventually, the peristosis becomes so powerful that it ejects food into the esophagus,

out of the mouth and across the room, and this is described as projectile vomiting.

Let's talk about the features.

Pyloric stenosis typically presents in the first few weeks of life with a hungry baby that is thin, pale and generally failing to thrive.

The classic description of vomiting that you should remember for your exams is projectile vomiting.

If you examine the baby after they've had a feed, you may be able to see

the powerful peristosis in the stomach by observing the abdomen. A firm round mass can be felt in the

upper abdomen that feels like a large olive, and this is caused by the hypertrophic muscle of the pylorus.

If you do a blood gas analysis, it will show hypochloric, meaning low chloride,

metabolic alkalosis, as the baby is vomiting the hydrochloric acid away from the stomach.

This is a common data interpretation question in your

exams so it's worth remembering this fact. Let's talk about the management. Diagnosis can be made

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