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Treatments and drugs
By Mayo Clinic staffPyloric stenosis is typically treated with a surgical procedure known as pyloromyotomy (pie-lor-oh-my-OT-uh-me). Surgery is often scheduled on the same day as the diagnosis. If your baby is dehydrated or has an electrolyte imbalance, surgery will be scheduled as soon as possible after these problems have been treated with fluid replacement.
Pyloromyotomy is done under general anesthesia. Traditionally, the procedure was done through a small incision in the baby's right upper abdomen or around the baby's navel. Today, however, pyloromyotomy is often done laparoscopically. With laparoscopic surgery, a slender viewing instrument (laparoscope) is inserted through a small incision near your baby's navel. The laparoscope is equipped with a laser and small surgical instruments. Recovery from the laparoscopic procedure is quicker than is recovery from a traditional open surgery, and the procedure leaves a smaller scar.
Before surgery, your baby may be given intravenous (IV) fluids to treat dehydration and restore electrolytes. During the procedure, the surgeon cuts and spreads apart the outside layer of the thickened pyloric muscles. The inside lining of the pylorus is left intact. After surgery, your baby may receive IV fluids for a few hours or until he or she can eat. Rarely, some vomiting occurs for a few days after surgery, however.
Potential complications of surgery include bleeding and infection. If the pyloric muscles aren't cut completely, your baby's signs and symptoms may return. Pyloromyotomy doesn't increase the risk of future stomach or intestinal problems.
Most infants return home within 48 hours. Your baby's doctor may request a follow-up visit after surgery to check on your baby's recovery.
- Olive AP, et al. Infantile hypertrophic pyloric stenosis. http://www.uptodate.com/home/index.html. Accessed June 23, 2010.
- Sondheimer JM, et al. Gastrointestinal tract. In: Hay WW Jr., et al. Current Diagnosis & Treatment: Pediatrics. 19th ed. New York, N.Y.: McGraw-Hill; 2007. http://www.accessmedicine.com/content.aspx?aID=3403837. Accessed June 23, 2010.
- D'Agostino J. Common abdominal emergencies in children. Emergency Medicine Clinics of North America. 2002;20:139.
- Guidelines for surgical treatment of infantile hypertrophic pyloric stenosis. Los Angeles, Ca.: International Pediatric Endosurgery Group. http://www.ipeg.org/education/guidelines/pyloric.html. Accessed July 7, 2010.
- Pyloric stenosis. The American Pediatric Surgical Association. http://www.eapsa.org//Surgeons/Content/NavigationMenu/Media/Resources/Pyloric_Stenosis.htm. Accessed July 7, 2010.
- Hoecker J (expert opinion). Mayo Clinic, Rochester, Minn. July 8, 2010.
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