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 and dehydration, such as adrenal insufficiency, gastroenteritis, UTI, inborn errors of metabolism and acute renal failure. projectile vomiting and and palpation of an olive in abdominal physical examination are very helpful to distinguish infantile pyloric stenosis from other common causes of vomiting in infants.

Differentiating Infantile Pyloric stenosis from Other Diseases

Pyloric stenosis must be differentiated from other diseases, such as:[1][2][3][4]

Preferred Table

Diseases History and Symptoms Physical Examination Laboratory Findings
Vomiting Persistent hunger Failure to gain weight Dehydration Palpation of an olive in abdomen Hypokalemia Acidosis or Alkalosis Hypochloremia or hyperchloremia
Infantile pyloric stenosis ++ ++ ++ ++ +/- + Alkalosis Hypochloremia
Adrenal insufficiency +/- +/- + + - Hyperkalemia or normal Acidosis Hypochloremia
Gastroenteritis ++ - +/- ++ - + Acidosis Hypochloremia
UTI +/- - - +/- - + Acidosis or alkalosis Hypochloremia or hyperchloremia
Acute renal failure +/- - - + - Hyperkalemia Acidosis Hyperchloremia

References

  1. Puttanna, A.; Cunningham, A. R.; Dainty, P. (2013). "Addison's disease and its associations". Case Reports. 2013 (jul26 1): bcr2013010473–bcr2013010473. doi:10.1136/bcr-2013-010473. ISSN 1757-790X.
  2. Elliott, E. J. (2007). "Acute gastroenteritis in children". BMJ. 334 (7583): 35–40. doi:10.1136/bmj.39036.406169.80. ISSN 0959-8138.
  3. Gil-Ruiz, Maite Augusta; Alcaraz, Andrés José; Marañón, Rafael José; Navarro, Nelia; Huidobro, Belén; Luque, Augusto (2011). "Electrolyte disturbances in acute pyelonephritis". Pediatric Nephrology. 27 (3): 429–433. doi:10.1007/s00467-011-2020-9. ISSN 0931-041X.
  4. Chambers JK (1987). "Fluid and electrolyte problems in renal and urologic disorders". Nurs Clin North Am. 22 (4): 815–26. PMID 3317287.

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