Paediatrics: Infant Pyloric Stenosis: Free MSRA Podcast

🍼 FREE MSRA PODCAST – Pyloric Stenosis: Spotting Projectile Vomiting in InfancyIn this episode, we break down pyloric stenosis—a must-know condition for MSRA paediatrics. Learn to recognise classic signs, avoid common diagnostic pitfalls, and understand key management steps, all based on high-yield UK guidelines.🧠 Key Learning Points📌 Definition• Narrowing/thickening of the pylorus (muscular outlet between stomach & duodenum) in infants• Blocks gastric emptying, usually from hypertrophy of circular muscle📌 Causes & Risk Factors• Exact cause unknown—thought to be multifactorial (genetic + environmental)• Major risks: first-born males, family history, early macrolide antibiotics (e.g. erythromycin), usually presents 3–6 weeks of age📌 Pathophysiology• Hypertrophied muscle → outflow obstruction• Genetics, possible hormones, early-life triggers📌 Differential Diagnosis (mnemonic: “GERM BAD”):Gastro-oesophageal refluxEnteritis (gastroenteritis)Reflux disease (GERD)Malrotation/atresia/volvulus (other surgical obstructions)Bowel atresiaAllergy (milk protein intolerance)Duodenal/oesophageal atresia📌 Epidemiology• 2–5/1,000 live births in the UK• 4:1 male:female• Rarer in non-white populations📌 Clinical Presentation• Projectile, non-bilious vomiting ~30–60 min after feeds• Persistent hunger, poor weight gain or weight loss• Palpable “olive” mass in RUQ/epigastrium• Signs of dehydration (dry mouth, sunken fontanelle, ↓ urine)• Visible gastric peristalsis (sometimes)📌 Diagnosis• Ultrasound: confirms diagnosis (muscle thickening/elongation)• Bloods: assess for hypochloraemic, hypokalaemic metabolic alkalosis (from vomiting), dehydration📌 Management• Pre-op: IV fluids, correct electrolytes FIRST• Definitive: Ramstedt’s pyloromyotomy (surgical split of muscle, often laparoscopic)• Rapid recovery and feeding restart after op📌 Prognosis & Complications• Excellent prognosis with prompt treatment• Complications (rare): recurrence, wound infection, persistent obstruction (very rare: foveolar cell hyperplasia)• Delay = risk of severe dehydration, metabolic disturbance📎 More MSRA Resources for Pyloric Stenosis📝 Revision Notes: https://www.passthemsra.com/topic/pyloric-stenosis-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/pyloric-stenosis-flashcards/💬 Accordion Q&A: https://www.passthemsra.com/topic/pyloric-stenosis-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/pyloric-stenosis-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/paediatrics-for-the-msra/#MSRA #PyloricStenosis #MSRARevision #MSRATextbook #Paediatrics #ProjectileVomiting #PassTheMSRA #MSRAQuiz #GPTraining #MSRAFlashcards #MSRAAccordions #ChildHealth