The pyloric sphincter is the valve that controls the passage of food from the stomach into the intestines (see figure 1).
Pyloric stenosis is caused by the muscle of the valve thickening. This usually results in your baby vomiting soon after a feed, before the food leaves the stomach. Often the vomiting is forceful (projectile vomiting). Because most of the goodness from a feed is absorbed into the body after the food leaves the stomach, your baby will become dehydrated and lose salts. This can be life-threatening and needs to be treated promptly.
What are the benefits of surgery?
Your baby should be able to feed normally after a couple of days.
Are there any alternatives to surgery?
If your baby is dehydrated, your surgeon may recommend giving them fluid and salts using a small tube placed in a vein (intravenous drip). However, this will not treat pyloric stenosis.
What does the operation involve?
Your surgeon will need to stabilise your baby’s fluid and salt levels using an intravenous drip.
The operation is performed under a general anaesthetic and usually takes between half an hour and three-quarters of an hour. Your surgeon will make a cut in the upper part of the abdomen or just above the umbilicus (tummy button) so they can get to the pyloric muscle. They will split the pyloric muscle and spread it apart to open the passage into the intestines. The muscle will heal on its own.
What complications can happen?
1 General complications of any operation
- Infection of the surgical site (wound)
- Unsightly scarring
2 Specific complications of this operation
- Vomiting after the operation
- Making a hole in the lining of the stomach
- Wound breakdown
- Developing a hernia in the wound
How soon will my baby recover?
Your surgeon will let you know when you should start to feed your baby again.
You will usually be able to take your baby home after three to four days.
Your baby should gradually return to normal feeding. Have your baby weighed regularly to make sure they are gaining weight.
Occasionally pyloric stenosis can come back.
Pyloric stenosis causes your baby to vomit soon after a feed, which prevents them getting goodness from their food. If left untreated the condition can cause dehydration and loss of salts. This can be life-threatening and needs to be treated promptly.
Paying for your procedure
Pyloromyotomy costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own procedure the cost will be explained and confirmed in writing when you book the procedure. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure.
Author: Mr Shailinder Singh DM FRCS (Paed. Surg.), Mr Simon Parsons DM FRCS (Gen. Surg.), Mr Jonathan Sutcliffe FRCS and Miss Glynda Preston RGN RSCN
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