Clinical Skills (Hypertrophic Pyloric Stenosis)

regu_7a_n.jpg: Technique of palpation of the pyloric tumor in hypertrophic pyloric stenosis. The most important conditions are 1) sedation of the infant with an artificially sweetened tea as shown in the drawing and 2) examination of the infant with warm index and middle fingers without any haste. In the right upper abdomen which is elevated by a roll, a firm olive-like mass (= pyloric tumor) can be palpated by smoothly moving both fingertips to and fro. By preference the first such examination should be performed preoperatively in the anesthetized and relaxed infant. regu_7b_n.jpg: Young infant with visible waves of hyperperistalsis during feeding. Above the navel and below the left costal margin localized protrusions of the thin abdominal wall are visible in this young infant. There are visible hyperstaltic waves caused by feeding which run from the gastric fundus to the antrum. They are pathognomonic for hypertrophic pyloric stenosis or other gastric outlet disorder.