Therapy OP
In the presence of pyloric stenosis, there is a predetermined treatment guideline that should be followed. First of all, oral feeding should be stopped immediately. The existing loss of fluid and electrolytes is compensated by the administration of infusions.
In addition, if vomiting persists, a probe can be inserted into the stomach via the nose to relieve the pressure. The subsequent standard therapy is the surgical splitting of the thickened pylorus muscles, the so-called pylorotomy. This is performed under general anesthesia and can be performed either by an open surgical procedure or by minimally invasive surgical procedures, such as endoscopic (laparoscopy).
The aim of the surgical treatment is to split the muscles of the stomach gate lengthwise without damaging the mucous membrane. The muscle ring at the exit of the stomach is pulled apart, thereby increasing its diameter to ensure unhindered food transport. In order to detect an accidental opening of the mucous membrane at the transition between the stomach and the small intestine, air can be introduced into the stomach via a gastric tube during the operation to see whether a defect becomes noticeable with the escape of air.
Early surgery is particularly recommended, as babies are still in good general condition at an early stage, which reduces the chance of complications. Mortality is very low at around 0.4% and in most cases is not due to complications of the operation, but to a previously insufficient and inadequate compensation of fluid losses, as well as shifts in blood salts. The prognosis after surgical splitting of the pylorus muscles is very good. Only in rare cases complications occur, such as wound infections, an incomplete splitting of the musculature, or an accidental opening of the mucosa at the transition from the stomach to the small intestine.
