NBME 20 Hypertrophic pyloric stenosis (NBME Answers)

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submitted by ∗hayayah(1212)

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Most common cause of gastric outlet obstruction in infants. Palpable olive-shaped mass in epigastric region, visible peristaltic waves, and nonbilious projectile vomiting at ∼2–6 weeks old.

Ultrasound shows thickened and lengthened pylorus. Treatment is surgical incision (pyloromyotomy).

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lovebug Could you explain WHY NOT (B) Gastric volvulus?? bc I think it can share some clinical symptoms. +2

calleocho305 This is what I put, wouldn't hps occur earlier than 4 weeks? +

ssc30 Gastric volvulus is very uncommon in general and almost never happens in infants. +2

ssc30 Gastric Volvulus would also present with severe abdominal distention and pain due to incarceration. +1

homersul gastric volvulus - non bilious emesis duodenal atresia - no peristaltic waves +

homersul duodenal atresia - bilious vomiting +

homersul https://fpnotebook.com/Surgery/GI/Vlvls.htm gastric volvulus is also common in the elderly, midgut volvulus is common in kids +