Child health · UKMLA & AKT
Pyloric stenosis
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise pyloric stenosis — the full SA Note notes add investigations, management, complications and 10 practice questions.
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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