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Vajnar J – A worried mother brings her 7–week–old infant to your office. She states that the infant is not gaining weight, that he seems to “spit up” everything given to him, and that he still seems hungry after vomiting. On physical examination, he appears thin but not jaundiced. There is a firm, mobile mass in the right upper quadrant (RUQ) of the abdomen. His mucous membranes appear dry. An upper GI series and ultrasonography (US) of the abdomen are performed...The differential diagnosis for pyloric stenosis should include gastroesophageal reflux, pyloric atresia, hiatal hernia, and malrotation of bowel. An upper GI series and US are the imaging studies used to evaluate for potential pyloric stenosis. Treatment of pyloric stenosis includes correction of electrolyte imbalances and dehydration as well as an immediate referral for pyloromyotomy, which may be done through an abdominal incision or laparoscopically. Some studies have evaluated nonsurgical treatment with atropine sulfate, but surgical correction remains the gold standard. It is most important to correct the infant's malnourished state and to promote weight gain.


   

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