Also known as Infantile Hypertrophic Pyloric Stenosis (IHPS)

Full stomach – Preoperative large-bore OG/NG tube to suction gastric contents. Rapid sequence induction (RSI).

Optimize hydration and electrolytes – Dehydration and electrolyte abnormalities should be optimized prior to surgery: This condition is considered a medical emergency but not a surgical emergency. The patient should be optimized, which typically takes 24-48 hours. Surgery can commence once Na > 130, K > 3.0, Cl > 85, with urine output of 1-2 ml/kg/hr.

Awake extubation – typically performed in the left lateral position

This is the most common cause of gastric outlet obstruction in children. The two muscles that comprise the pylorus hypertrophy, which causes obstruction. This causes fluids and ingested food to back up. The exact cause is unknown.

Signs and symptoms include non-bilious projectile vomiting 30-60 minutes after feeding, olive-like mass palpable in the right upper quadrant, dehydration, electrolyte abnormalities, and weight loss.

Electrolyte abnormalities demonstrate hypokalemia, hypochloremic metabolic alkalosis, and compensatory respiratory acidosis.

Incidence: 2-4 per 1000 live births, affecting males more than females (4:1), with Caucasian males being the most affected. 95% of patients with this condition are identified between 3-12 weeks of age.

Low mortality