A 2.5-week-old boy is brought to pediatrics emergency depament with projectile vomiting which is non-bilious. On physical examination, firm, olive like mass is noted in the epigastric region and USG revealed the following findings. The child underwent surgical management. On week later, the child presents again with loose stools after being breastfeed. What could be the etiology of the current episode diarrhea?
The clinical symptoms, examination with USG findings of thickened pyloric muscle (>3mm) and elongated pyloric canal (>15mm) reveal the diagnosis as CHPS- congenital hyperophic pyloric stenosis. The management image represents surgical pyloromyotomy. Post surgical management - pyloric sphincter dysfunction leads to delivery of hyperosmotic chyme from stomach to small intestine, which it cannot process leading to OSMOTIC DIARRHEA. This is known as DUMPING syndrome and is responsible for the week's later symptoms.
Post-operative infection
Rotavirus
Dumping syndrome
Non resolution of the pre-op symptoms
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