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Estenose pilórica

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 20 Aug 2025
Last updated: 05 Jan 2024

Summary

Definition

History and exam

Key diagnostic factors

  • menino primogênito
  • vômitos não biliosos em jato
  • 2 a 12 semanas de idade
  • massa abdominal superior
  • ondas peristálticas
Full details

Other diagnostic factors

  • história familiar de estenose pilórica
  • várias alterações de fórmula
  • taquicardia
  • menor número de fraldas molhadas
  • membranas mucosas ressecadas
  • fontanelas planas ou deprimidas
  • constipação
  • baixo ganho de peso
  • irritabilidade
Full details

Risk factors

  • prematuridade
  • exposição precoce à eritromicina
  • exposição a prostaglandinas
  • exposição materna a macrolídeos
  • localização geográfica/origem étnica
  • menino primogênito
  • história familiar de estenose pilórica
Full details

Diagnostic investigations

1st investigations to order

  • perfil bioquímico
  • ultrassonografia do abdome
Full details

Treatment algorithm

ACUTE

todos os pacientes

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

Disclosures

RH declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Aspelund G, Langer JC. Current management of hypertrophic pyloric stenosis. Semin Pediatr Surg. 2007 Feb;16(1):27-33. Abstract

Expert Panel on Pediatric Imaging., Alazraki AL, Rigsby CK, et al. ACR Appropriateness Criteria® Vomiting in infants. J Am Coll Radiol. 2020 Nov;17(11s):S505-S515.Full text  Abstract

Staerkle RF, Lunger F, Fink L, et al. Open versus laparoscopic pyloromyotomy for pyloric stenosis. Cochrane Database Syst Rev. 2021 Mar 9;3:CD012827.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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