Pyloric stenosis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

• Infantile hypertrophic pyloric stenosis must be differentiated from other diseases that cause vomiting, poor feeding, dehydration, such as adrenal insufficiency, gastroenteritis, UTI, and acute renal failure.

Differentiating Pyloric Stenosis from Other Diseases

Pyloric stenosis must be differentiated from other diseases, such as:

• Adrenal insufficiency
• Gastroenteritis
• Inborn errors of metabolism
• Urinary tract infections and Pyelonephritis
• Acute renal failure

Preferred Table

Diseases	History and Symptoms			Physical Examination				Laboratory Findings			Other Findings
	Vomiting	Persistent hunger	Failure to gain weight	Dehydration	Physical Finding 2	Physical Finding 3	Physical Finding 4	Hypokalemia	Acidosis or Alkalosis	Hypochloremia or hyperchloremia
Infantile pyloric stenosis	++	++	++	++				+	Alkalosis	Hypochloremia
Adrenal insufficency	+/-	+/-	+	+				Hyperkalemia	Acidosis	Hypochloremia
Gastroenteritis	++	-	+/-	++				+	Acidosis	Hypochloremia
UTI	+/-	-	-	+/-				+/-	Acidosis or alkalosis	Hypochloremia or hyprchloremia
Acute renal failure	+/-	-	-	+				Hyperkalemia	Acidosis	Hyperchloremia