Summary
Definition
History and exam
Key diagnostic factors
- first-born male infant
- non-bilious projectile vomiting
- 2 to 12 weeks old
- upper abdominal mass
- peristaltic waves
Other diagnostic factors
- family history of pyloric stenosis
- multiple formula changes
- tachycardia
- decreased wet nappies
- dry mucous membranes
- flat or depressed fontanelles
- constipation
- poor weight gain
- irritability
Risk factors
- prematurity
- early exposure to erythromycin
- exposure to prostaglandins
- maternal exposure to macrolides
- geographic location/ethnic background
- first-born male infant
- family history of pyloric stenosis
Diagnostic investigations
1st investigations to order
- chemistry panel
- ultrasound abdomen
Treatment algorithm
all patients
Contributors
Authors
Catherine J. Hunter, MD
Professor of Surgery and Division Chief of Pediatric Surgery
Oklahoma Children’s Hospital
The University of Oklahoma College of Medicine
Oklahoma City
OK
Disclosures
CJH declares that she has no competing interests.
Acknowledgements
Dr Catherine Hunter would like to gratefully acknowledge Dr Samuel C. Klonoski, Dr Jeffrey S. Upperman, Dr Yigit S. Guner, and Dr Arturo Aranda, previous contributors to this topic. SCK, JSU, YSG, and AA declare that they have no competing interests.
Peer reviewers
Evan Nadler, MD
Assistant Professor of Surgery
Department of Surgery
Division of Pediatric Surgery
NYU Medical Center
New York
NY
Disclosures
EN declares that he has no competing interests.
Lewis Spitz, PhD FRCS MD (Hon), FRCPCH FAAP (Hon), FCS (SA) (Hon)
Emeritus Nuffield Professor of Paediatric Surgery
Institute of Child Health
University College
London
UK
Disclosures
LS declares that he has no competing interests.
Ruth Hallows, BSc, MB BS, FRCS, FRCS III (Paediatric Surgery)
Consultant in Paediatric and Neonatal Surgery
Royal Alexandra Children's Hospital
Brighton
UK
Declarações
RH declares that she has no competing interests.
Diagnósticos diferenciais
- Gastro-oesophageal reflux
- Over-feeding
- Malrotation
Mais Diagnósticos diferenciaisDiretrizes
- ACR appropriateness criteria: vomiting in infants
Mais DiretrizesConectar-se ou assinar para acessar todo o BMJ Best Practice
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