HPS: A Case Study

HYPERTROPHIC PYLORIC STENOSIS: It is the type obstruction that is common on infants where by the antra muscle at the orifice of pylorus hypertrophy and causes obstruction (BONTRAGER, 2014). Symptoms of HPS starts showing up within three to six weeks after birth and in rare case for babies at the age of older than 3 month (STAFF, 2012). This may include projectile vomiting after feedings, acute pain, distension of stomach, and in prolonged delay in diagnosis can lead to dehydration, abdominal pain, dehydration, burping, and failure to gain weight or weight loss. (BONTRAGER, 2014) (KANESHIRO, 2013) DIAGNOSIS:
Diagnosis for the pyloric stenosis usually diagnosed before the age of 6 months. HPS can be diagnosed through physical examination,
Presence of the hypertrophic pyloric muscle mass, olive, in this region is used as a diagnosis for HPS. Palpation of the olive requires no additional diagnostic testing. Also, in some cases visibility of gastric distention or visible gastric distention peristalsis may be seen in some cases on the left upper quadrant to the epigastum (CINCINNSTI CHILDREN'S, 2007). 2. LABORATORY TEST
Laboratory test for HPS includes checking the electrolyte imbalance which includes the hypochloraemic, hypokalemic metabolic alkalosis. Hypochloraemic is due to loss of hydrochloric acid in the vomited fluids. Hypokalemia resulted from excretion of potassium from the kidney to compensate the hydrogen lost from the vomits. This is seen for patients with the problem for more than three weeks (DAVIES, 2012). 3. RADIOGRAPHIC EXAMINATION.
Hypertrophic pyloric stenosis can be diagnosed using ultrasound and fluoroscopy. Ultrasound is the primary imaging modality in imaging method for diagnosing hypertrophic pyloric stenosis since it’s noninvasive method using no radiation though fluoroscopy is superior in diagnosing condition related to vomiting, reflux, or malrolation (CINCINNSTI CHILDREN'S, 2007). The normal size for the pyloric antrum is approximately 2.5cm in length and length 10 – 14mm and increase of the thickness to 3mm and increase in diameter to 15mm is considered as pyloric stenosis (DAVIES,
Blood sample is taken for checking sodium, potassium, carbon dioxide, and chloride amount (CARLIFONIA, 2015). As the electrolytes balanced surgery follows where by small cut will be make in the pylorus either longitudinally or circular muscles, and this is called the Ramstedt Pyloromyotomy operation. The small incision made to the pyloric region will allow the pyloric muscle to stretch out whereby allowing the stomach to empty the food. Incision to the muscle can be done through open pyloromyotomy, circumbilical incision, or laparascope which is the safe, cost effective, and lower incidence of infection (JAMIE LIEN,