PSYCH 2B03 Lecture Notes - Lecture 6: Pyloric Stenosis, Capillary Refill, Dehydration
13 Aug 2020
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Definition: involuntary passage of gastric contents into the oesophagus due to inappropriate relaxation of the lower oesophageal sphincter. Henry 3 month of old boy comes to gp surgery. Vomiting a small quantity of milk post feed. Feeding breast fed exclusively, good appetite, weighs approx 4 kg . Growing steadily, stayed on the same centile in his red book. Lives at home with mum and dad. Basic obs: temp- 36. 5 c, hr-130, rr-20, bp-80/40 mmhg, spo2- 98% ra. Hydration status: peripheral capillary refill 1s, normal skin turgor and moist mucous. Abdo exam: no organomegaly, masses or tenderness on abdominal examination. There are no signs in the other systems. To assess severity: 24-hour oesophageal ph monitoring. ph <4 for several hours is indicative of. Majority resolve spontaneously by 18 months of age. 30 head up prone positioning after feeds. H2 receptor antagonist (ranitidine) or ppi (omeprazole) Enhance gastric emptying and increase lower oesophageal pressure (domperidone)
