A baby, who was apparently normal at bih, develops persistent regurgitation and vomiting in the second and third weeks of life. No fever is present and hematologic studies and blood chemistries are normal. Which of the following therapies is most likely to be effective in this case?
The baby probably has congenital hyperophic pyloric stenosis, which usually presents at several weeks of age. Paial surgical incision through the pylorus (pyloromyotomy) is usually curative. Antacids are beneficial in esophageal reflux and peptic ulcer disease. Barium enema can reverse intussusception in a child, but would not be therapeutic in this case. Gastric resection is not indicated, since the much less invasive procedure of pyloromyotomy is actually more effective. Ref: Hackam D.J., Grikscheit T.C., Wang K.S., Newman K.D., Ford H.R. (2010). Chapter 39. Pediatric Surgery. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e.
Antacids
Barium enema
Gastric resection
Pyloromyotomy