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Pyloromyotomy


About this topic


The pylorus is the muscle connecting your childs stomach to the intestines. This muscle controls the flow of stomach contents into the intestines. Sometimes in babies, this muscle becomes narrow and thick. Then, food is blocked in the stomach. This problem is called pyloric stenosis. With pyloric stenosis, your child has problems digesting food. Many children throw up forcefully. This sign may start as early as 3 to 12 weeks old. Sometimes, children do not show signs until later in childhood. ‚  
Your child may need surgery to fix the problem. The surgery is called a pyloromyotomy. The doctor will open the thick muscles, fixing the blocked passage. The doctor can either make one large cut on the belly for an open procedure or a few small cuts to do a laparoscopic procedure. Talk with the doctor about the best way to fix your child's pyloric stenosis. ‚  

What will the results be?


This surgery will widen your childs stomach opening. Then, foods will be able to move through and be digested. ‚  

What are the main signs?


A baby with pyloric stenosis may: ‚  
  • Throw up with force
  • Throw up soon after a feeding
  • Throw up nearly all the milk drank
  • Act hungry right after throwing up
  • Have a full, swollen upper belly after a feeding
  • Act very fussy
  • Have fewer and harder stools than normal
  • Pass less urine than normal

What happens before the procedure?


  • The doctor will take your childs history. Talk to the doctor about:
    • All the drugs your child is taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs your child takes with you.
    • Any bleeding problems. Be sure to tell the doctor if your child is taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. Your child may need to stop these drugs as well. Talk to your doctor about them.
    • When your child needs to stop eating or drinking before the procedure.
  • The doctor will do an exam and may order:
    • Lab tests
    • X-rays
    • Ultrasound of your child's belly
    • Upper GI series

What happens during the procedure?


  • You may be allowed to go into the operating room until your child is asleep.
  • Once in the operating room, the doctors will give your child a drug to make them sleepy. It will also help your child stay pain free during the surgery. The staff will put an I.V. in your childs arm to give fluids and drugs.
  • The doctor can do the procedure in one of 2 ways:
    • An open pyloromyotomy ¢ ˆ ’ The doctor makes 1 larger cut on the belly
    • A laparoscopic pyloromyotomy:
      • The doctor will make 3 to 4 small cuts in your child's belly.
      • The doctor puts in a scope with a tiny camera through one of the small cuts to look at the stomach. The doctor will put small surgical tools into the holes to do the procedure.
  • The doctor may put gas in the abdomen to help view the site.
  • The narrow part of the stomach opening will be stretched and opened up.
  • The doctor will close each cut with stitches or staples and cover it with clean bandages.
  • The surgery will take 1 to 2 hours.

What happens after the procedure?


  • Your child will go to the Recovery Room for a few hours and then to a hospital room.
  • The staff will watch your child closely. The doctor may give your child drugs for pain.
  • Feeding can be resumed in most infants within a few hours after surgery.
  • Mild spitting up is common after the procedure.
  • Your child may need to stay in the hospital 1 to 3 days.

What drugs may be needed?


The doctor may order drugs to: ‚  
  • Help with pain
  • Prevent or fight an infection

What problems could happen?


  • Bleeding
  • Infection
  • Leaking of the stomach contents
  • Throwing up often occurs for 2 days, up to 5 days after the surgery

Where can I learn more?


KidsHealth ‚  
http://kidshealth.org/parent/medical/digestive/pyloric_stenosis.html ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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