Child health · UKMLA & AKT
Pyloric stenosis
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Typical age: 3-8 weeks, often male, first-born
- Projectile, non-bilious vomiting - forceful, immediately after feeds; non-bilious because obstruction is proximal to the ampulla of Vater (bile enters at 2nd part of duodenum)
- Persistent hunger - feeds voraciously again immediately after vomiting ('hungry vomiter')
- Visible gastric peristalsis - left-to-right wave across upper abdomen
- Palpable olive-shaped mass - firm, mobile pyloric tumour in right upper quadrant/epigastrium, best felt during test feed
- Signs of dehydration - reduced skin turgor, dry mucous membranes, sunken fontanelle, reduced urine output
Non-bilious vomiting = obstruction proximal to ampulla of Vater. Bilious vomiting in a neonate is a red flag for distal obstruction (e.g. malrotation, duodenal atresia) until proven otherwise.
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