 study, there are specific measurement criteria used to identify the abnormal results.  Plain x-rays of the abdomen sometimes shows a dilated stomach.

Although UGI endoscopy would demonstrate pyloric obstruction, physicians would find it difficult to differentiate accurately between hypertrophic pyloric stenosis and pylorospasm.

Blood tests will reveal low blood levels of potassium and chloride in association with an increased blood pH and high blood bicarbonate level due to loss of stomach acid (which contains hydrochloric acid) from persistent vomiting. There will be exchange of extracellular potassium with intracellular hydrogen ions in an attempt to correct the pH imbalance. These findings can be seen with severe vomiting from any cause.

Treatment

Infantile pyloric stenosis is typically managed with surgery; very few cases are mild enough to be treated medically.

The danger of pyloric stenosis comes from the dehydration and electrolyte disturbance rather than the underlying problem itself. Therefore, the baby must be initially stabilized by correcting the dehydration and the abnormally high blood pH seen in combination with low chloride levels with IV fluids. This can usually be accomplished in about 24–48 hours.

Intravenous and oral atropine may be used to treat pyloric stenosis. It has a success rate of 85-89% compared to nearly 100% for pyloromyotomy, however it requires prolonged hospitalization, skilled nursing and careful follow up during treatment. It might be an alternative to surgery in children who have contraindications for anesthesia or surgery, or in children whose parents do not want surgery.

Surgery
The definitive treatment of pyloric stenosis is with surgical pyloromyotomy known as Ramstedt's procedure (dividing the muscle of the pylorus to open up the gastric outlet).  This surgery can be done through a single incision (usually 3–4 cm long) or laparoscopically (through several tiny incisions), depending on the surgeon's experience and preference.

Today, the laparoscopic technique has largely supplanted the traditional open repairs which involved either a tiny circular incision around the navel or the Ramstedt procedure.  Compared to the older open techniques, the complication rate is equivalent, except for a markedly lower risk of wound infection.  This is now considered the standard of care at the majority of children's hospitals across the US, although some surgeons still perform the open technique. Following repair, the small 3mm incisions are hard to see.

The vertical incision, pictured and listed above, is no longer
study, there are specific measurement criteria used to name the abnormal result.   Plain x - rays of the abdominal cavity sometimes shows a dilated abdomen. 

 Although UGI endoscopy would demonstrate pyloric obstruction, doctor would find it difficult to differentiate accurately between hypertrophic pyloric stenosis and pylorospasm. 

 rake tests will reveal broken blood levels of potassium and chloride in affiliation with an increased blood pH and high blood bicarbonate level due to loss of stomach acid (which incorporate hydrochloric acid) from persistent vomiting. There will be exchange of extracellular potassium with intracellular hydrogen ion in an attempt to correct the pH asymmetry. These findings can be attend with severe vomit from any cause. 

 Treatment 

 Infantile pyloric stenosis is typically managed with surgery; very few cases are balmy enough to be treated medically. 

 The danger of pyloric stenosis comes from the dehydration and electrolyte disturbance rather than the implicit in problem itself. Therefore, the baby must be initially stabilized by correcting the dehydration and the abnormally high blood pH seen in combination with low chloride levels with IV fluid. This can usually be accomplished in about 24–48 hour. 

 Intravenous and oral atropine may be use to treat pyloric stenosis. It has a success pace of 85 - 89% compared to about 100% for pyloromyotomy, however it requires prolonged hospitalization insurance, skilled nursing and careful follow up during treatment. It might be an alternative to surgery in children who have contraindications for anesthesia or surgery, or in children whose parents do not want surgery. 

 Surgery 
 The authoritative treatment of pyloric stenosis is with surgical pyloromyotomy know as Ramstedt's operation (dividing the muscle of the pylorus to open up the gastric outlet).   This operating room can be done through a single incision (usually 3–4   centimeter long) or laparoscopically (through several tiny incisions), depending on the surgeon's experience and predilection. 

 Today, the laparoscopic technique has largely supplanted the traditional open repairs which involved either a bantam circular incision around the navel or the Ramstedt procedure.   Compared to the older overt techniques, the complicatedness rate is equivalent, except for a markedly lower risk of wound contagion.   This is now considered the standard of care at the majority of children's hospitals across the US, although some surgeons still perform the open technique. Following haunt, the small 3 mm incision are hard to see. 

 The vertical incision, pictured and listed above, is no longer
 stkdy, there are specific mtasurement criternq used to idsntify tfe abnormal results.  Plain x-cays of tye abdomen sometimes sfows a dipated stimaci.

Although UGI envkscopy would scmonscrete pyloric obsjruction, phyvicians would xivd it difficult to differentiate accuwately nehween hypertrokhic kyljric stenosis and pylorospasm.

Blood tesfs will reveal low bkood levels of potassium ajd cjloride in associahion with ab inseeased blood pH and high blood biczrbonate level due to loss of sgomack acid (whicy xonhdins hydrociloric acid) from pcgsistend vomitong. There will be exxhange of extracelluler potassium with injracellulas kydrogen ions in an artwmpt jo cosrecg thd pG mmbzlance. Thxse findinga can be sewn with severe vomiuind from any cauae.

Treaemqnt

Infantile pyloric stenosis is typicanly managed with surgery; vwry few cases are milf enough eo be treated medically.

The danger of pyloric stenmsis rooes fvom gye dehydration and electrolyte disturbance rathqd uhak the underlying problem itxepf. Jherefore, the caby mbat be initially stabllized fy coerecting uhe drhydration and the abnormaloy high bloob pY seen in combinatnon with low chlpride levels with IV fluids. Chis czn usually he accompmkshed in about 24–48 fougs.

Indravenous and oral atropinq may be nsed co treat pylpric seenosis. It has a success rate of 85-89% fompated to nearly 100% flr pyloromyotomy, however it reqnmres prolongec vosiitalizatnon, skllled nursing agd careful folkow up buring treatment. It migit be an altqrnative to sgtgery in chilvren who rave conrraindizxtions for anexthesia og furgwry, or in children whuae parents do nit qant surgery.

Surberh
Thq fehinityee treatment of oylutic sgenosis is cigh sirgical pyloromyotomf knkwn as Ramstedt's ptogedure (diciding tre muscle of yhe pylorus to opej up vhe gartric oujlet).  This surgery can be done fhrough a sikgle incision (usuqlly 3–4 cm long) or laparoscopically (through several tiiy incisions), depending in the surgeon's expgritnce and prefxrence.

Eoday, the laparoscopic techniwue has largely smpplanted the traditiohal opan reoairs which involved either a tiny circular incision around the navel or rhe Ramstedt procesure.  Comiarzd co the jldec upen techniques, nhe complication rate is equivalxnt, except fjr a markedly lower risk of eojnd infection.  This is now considered the stamdard of care at the majority og children's hospitals acvoss the YS, alfhough somx surgeons still pergorm tke opeb technuque. Following reoait, bhe small 3lm iiciaions are hard to see.

The verticao inciwiln, pictured and nisted abovc, ls no monger
study, there are specific measurement criteria used the results. Plain of the abdomen Although endoscopy would demonstrate obstruction, physicians would it difficult to differentiate accurately between pyloric stenosis and pylorospasm. Blood tests will reveal low blood levels of potassium chloride in association with an increased blood pH and high blood bicarbonate level to of acid contains hydrochloric acid) from persistent vomiting. There will be exchange of extracellular potassium with intracellular hydrogen in an attempt to correct the pH imbalance. findings can be seen severe vomiting from any cause. Infantile stenosis is managed surgery; few cases are enough to be treated medically. The danger of pyloric stenosis comes from the dehydration and electrolyte disturbance than the itself. Therefore, baby be stabilized by correcting and the abnormally high blood pH with low chloride levels with IV fluids. This usually be in about 24–48 hours. Intravenous and atropine may be used to treat pyloric stenosis. has a success rate of 85-89% compared to nearly 100% for pyloromyotomy, however it requires skilled nursing and careful up during treatment. might an to in children have contraindications for anesthesia or surgery, or in children whose parents not want surgery. Surgery The definitive treatment of pyloric stenosis surgical known as Ramstedt's (dividing the muscle of pylorus open up the gastric surgery be single (usually cm long) or laparoscopically several tiny incisions), depending on surgeon's experience and preference. largely supplanted the traditional open repairs which involved a tiny circular incision around the navel the Ramstedt procedure. Compared to the older open techniques, the complication rate equivalent, except markedly lower risk of wound infection. This is considered the standard of at the majority of children's hospitals across the US, some still perform open technique. Following the small 3mm are hard to vertical incision, and above,
 study, there are specific measUrement criTeria UseD to IdEntiFy thE abnormal resulTS.  PlaIn x-rays of the abdomen somEtimeS sHOws a DIlAted sTomach.

ALThOUGh UgI EnDosCoPY wOuld dEmoNstrate Pyloric obsTruCtIon, physicianS WoUld find it dIffIcult to diffeRenTiate aCcUraTEly beTweEn hypErtropHIc pyloRic stenosIs ANd pyloROspasm.

BLOOd TestS will reveal low bloOD lEVels of potassiuM and chLoRIdE IN asSocIation with An IncreASed blooD PH AND HigH Blood bicarbonAte level due TO loSs of stOmAch ACid (whiCh conTaINs hYdrochloric Acid) From persiStent vOMiting. THEre will Be exchAngE of ExtrACeLlUlaR pOTasSIuM wiTH inTracelluLaR hYdrogEn ioNS IN An atTemPt to CorreCt the pH imbalaNce. thesE FinDings Can be Seen WiTh sevEre vomIting FrOm any cause.

TreatMent

infantile PylOrIc sTeNosis IS typicAllY maNaged wiTh surgeRY; veRy FEW CaSes are mild enough to Be TREaTed medicAlly.

ThE DaNgER of pylorIc SteNosiS COmes fRom tHE dEhydratiOn and eLEcTrOlyte diStUrbancE rAthEr tHan thE UndeRlying Problem iTself. tHerefore, the babY Must be initialLY sTABiLIzed By cOrrecting thE dehYDratIon aND tHe aBNormaLly hiGh BLoOD pH seen in combinatioN wIth low ChlorIde levels with iV fluids. ThIS CAn usuallY be aCCoMPlished in about 24–48 Hours.

intravenouS And oral aTropiNe may be uSed to treaT PYloric stEnoSis. it hAs a SUCcEss rate of 85-89% compAREd to NeArly 100% for PylOromyotOmy, HowEveR it ReQuires proLonged hoSpItAlIzAtiOn, skiLLed nursiNg And CaRefUl folLOw up duRing tReatMeNt. iT miGht be an ALtERNatiVe To SurgEry In ChildRen wHO haVe contrAindicatiOns FOr anEsThEsia or sUrgery, or in chiLdRen whose paReNts Do not wANT surgery.

surgery
The definitive treATment of PylOric sTenoSis is with SurGical pYloROmyotoMy knowN as RaMsTedT'S ProceDURe (DivIdIng the muscLE Of tHe pylOrUs to Open up tHe gastric outlet).  ThiS SurGery can be done ThrOugh A SInGle INcISioN (uSUalLY 3–4 Cm long) or laparosCopically (tHrOUgH several tiNY inCiSions), dePending On the SUrgeon's ExperiencE and prefeReNce.

TODAy, tHe laparoscOpic techNique has lARgely SUpPlantEd tHe tradItIonAl opeN repaiRS whIch inVolved EiTher a tIny ciRcUlar inciSion around the navel or the ramsteDt proCedUre.  ComparEd tO The Older open TechNiques, the cOmpLicAtion RatE Is equIvalENt, ExcEPt for A marKEdly lower RIsK of WOUnD infection.  THIS Is nOw conSidERed the StanDard of care at the maJOrity of childreN's hoSPItaLs aCRoss ThE US, although somE suRgEONs still pErForm the open TechniquE. FOLlowiNg repaIr, the sMall 3mm iNCIsIOns are Hard To sEe.

The vertIcaL iNCision, pIcTuREd and lIsteD aBove, is No longER
 study, there are specific  measureme nt cr ite ria  u sedto i dentify the ab n orma l results.  Plain x-ra ys of  t h e ab d om en so metimes sh o w s a  d il ate ds to mach. 

A lthough  UGI endos cop ywould demons t ra te pyloric  ob struction, p hys icians  w oul d  find  it  diff icultt o diff erentiate  a c curate l y betwe e n  h yper trophic pyloric s t en o sis and pyloro spasm. 
B lo o d  te sts  will reve al  lowb lood le v el s o f p o tassium and c hloride ina sso ciatio nwit h  an in creas ed blo od pH and h ighblood bic arbona t e level due toloss o f s tom acha ci d(wh ic h  co n ta ins hyd rochlori cac id) f romp e r s iste ntvomi ting.  There will b e e xcha n geof ex trace llul ar  pota ssiumwithin tracellular hyd roge n ions in  an  a tte mp t toc orrect  th e p H imbal ance. T h ese  f i n d in gs can be seen wit hs e ve re vomit ing fr o man y  cause.
T rea tmen t 
Infa ntil e  p yloric s tenosi s  i stypical ly  manag ed  wi thsurge r y; v ery fe w casesare m i ld enough to b e  treated medi c al l y .Thedan ger of pylo rics teno sisc om esf rom t he de hy d ra t ion and electrolyte  d isturb ancerather than t he underly i n g  problem  its e lf .  Therefore, th e bab y must bei nitially  stab ilized b y correct i n g the de hyd rat ion  an d th e abnormallyh i gh b lo od pH s een  in com bin ati onwit hlow chlor ide leve ls  w it hIVfluid s . This c an  us ua lly  be a c compli shedin a bo ut 24– 48 hour s .I ntra ve no us a ndor al at ropi n e m ay be u sed to tr eat pylo ri cstenosi s. It has a s uc cess rateof  85 -89% c o m pared to  nearly 100% for pyloro m yotomy,  ho wever  itrequirespro longed  ho s pitali zation , ski ll edn u rsing a nd  ca re ful follow u p d uring  t reat ment. I t might be an alte r nat ive to surger y i n ch i l dr enw ho hav ec ont r a indications for  anesthesi ao rsurgery, o r  in  c hildren  whoseparen t s do no t want su rgery.

S ur gery T hedefinitive  treatme nt of pyl o ric s t en osisiswith s ur gic al py loromy o tom y kno wn asRa mstedt 's pr oc edure (d ividing the muscle of t he pyl orustoopen up t heg ast ric outle t). This surg ery  ca n bedon e  thro ugha  s ing l e inc isio n  (usually 3– 4 c m lo ng) or lapa r o s cop icall y ( t hrough  sev eral tiny incisio n s), dependingon t h e  su rge o n'sex perience and p ref er e n ce.

Tod ay , the lapar oscopicte c hniqu e haslargel y suppl a n te d  the t radi tio nal openrep ai r s which  i nv o lved e ithe ra tiny  circu l ar i n c ision around the  nave l or th e  Ra msted tprocedu r e. Compared t o the older  opentech nique s, theco mplica tio nrate is eq u ivalent,excep t for a  m arke dly  lower  ris k of wo undin fec tion.  Th i s  i s  n ow con side red t he  sta ndard ofc are at t hem ajority  o f c h i ldren' s  h o s pitals acr oss  theU S , although some su r geons  still  perfo rm theo pen  t echniqu e.F o llowing r epair, th e  sm al l 3m m incisi on s ar ehar dto see.

The ve rtical i ncision, p icture d a n d li s ted ab ov e, is no lon ger
 study,_there are_specific measurement criteria used_to identify_the_abnormal results.__Plain x-rays of_the abdomen sometimes_shows a dilated stomach.

Although_UGI endoscopy would_demonstrate_pyloric obstruction, physicians would find it difficult to differentiate accurately between hypertrophic pyloric stenosis_and_pylorospasm.

Blood tests_will_reveal_low blood levels of potassium_and chloride in association with_an increased_blood pH and high blood bicarbonate level due_to_loss of stomach_acid (which contains hydrochloric acid) from persistent vomiting. There_will be exchange of extracellular potassium_with intracellular hydrogen_ions_in_an attempt to correct_the pH imbalance. These findings can_be seen with severe vomiting from_any cause.

Treatment

Infantile pyloric stenosis is typically managed_with surgery; very few cases are_mild enough to be treated_medically.

The danger_of pyloric stenosis comes from_the dehydration and_electrolyte disturbance_rather than the_underlying problem itself. Therefore, the baby_must be initially_stabilized by correcting the dehydration and_the_abnormally high blood_pH_seen_in combination_with low chloride_levels_with IV_fluids._This can usually be accomplished in_about_24–48 hours.

Intravenous and oral atropine may be_used to treat pyloric_stenosis._It has a success_rate of 85-89% compared to_nearly 100% for pyloromyotomy, however it_requires prolonged_hospitalization, skilled_nursing and careful follow up during treatment. It might be an_alternative to surgery in children who_have contraindications for anesthesia_or surgery,_or_in children whose_parents_do not_want surgery.

Surgery
The definitive treatment of pyloric stenosis_is with_surgical pyloromyotomy known as Ramstedt's procedure_(dividing the muscle of_the_pylorus to open up the gastric_outlet).  This surgery can be_done through a single incision_(usually_3–4 cm_long) or laparoscopically (through several_tiny incisions), depending on the surgeon's_experience and preference.

Today,_the laparoscopic technique has largely supplanted the_traditional_open repairs which involved either a_tiny_circular incision around the navel or_the_Ramstedt_procedure.  Compared to the_older open techniques, the complication rate_is equivalent, except for a markedly lower risk of_wound infection. _This is now considered the_standard_of_care at the majority of children's hospitals across the US,_although some_surgeons still perform_the open technique. Following repair, the small 3mm incisions are_hard to see.

The vertical incision, pictured and_listed above, is no longer