<prompt> The abdominal mass in pyloric stenosis in a new born child can be best palpated:During feedingIn the umbilical areaIn the epigastric areaIn the right hypochondriac quadrant  <response>: Ref. Sabiston Textbook of Surgery. Pg. 1869 BackgroundHypertrophy of the pyloric sphincter causes narrowing of the gastric outletMost common cause of gastric obstruction in patients 2-12 weeks oldRisk factors include male 4:1; firstborn 2:1; whitecaucasian; term infants; bottle-fed babiesPresentationUsually present around 3-6 weeks with a history of progressively worsening non-billious vomiting may be projectileAssociated with poor weight gain, decreased urine output fewer wet nappies and stools, excessive hunger, dry mucous membranes and depressed fontanelleExamination of the abdomen may reveal an epigastric olive-shaped massManagementFluid resuscitation- correct any electrolyte disturbance particularly hypokalaemia prior to surgeryNil by mouth and nasogastric drainage or suction prior to surgery and between feedsSurgery Pyloromyotomy 