PAEDIATRICS
PYLORIC STENOSIS
There will be a gas - hypochloraemic metabolic alkalosis
PromptClinical findings in pyloric stenosis
ResponseRUQ mass (olive)
Non bilious projectile vomiting
Peristaltic waves
Abdo distension
Non bilious projectile vomiting
Peristaltic waves
Abdo distension
PromptBlood gas Findings in pyloric stenosis
ResponseHypochloremic (hypokalaemic) metabolic alkalosis
- Met alk - H+ loss in vomit
- Hypokalaemia - Loss of HCl in vomitus - intracellular exchange of Cl with K to balance alkalosis >> hypokalaemia (pH shift into cells, less so K+ loss in vomiting)
- Expected pCO2 = 0.7 x [HCO3] + 20
PromptNeonate with blood gas in the exam question DDx
ResponseCAH - hyperkalaemic, hyponatraemic, metabolic acidosis
Pyloric stenosis - Hypochloraemic metabolic alkalosis.
Pyloric stenosis - Hypochloraemic metabolic alkalosis.
PromptUltrasound in pyloric stenosis
ResponsePyloric thickening
Target/donut sign
Septic workup - exclude sepsis
AXR - rule out malrotation or obstruction
Target/donut sign
Septic workup - exclude sepsis
AXR - rule out malrotation or obstruction