Dawaa Reference

Clinical reference

Infantile pyloric stenosis

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD55.01 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Pyloric Stenosis - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK555931/

Verified against2 documents
  • No dose - referral pathway, no medicine given in primary care
  • Infantile pyloric stenosis - disease-level clinical article (pyloric-stenosis-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (2)

  • Vomiting is forceful and never bile-tinged, and may follow every feed or come and go. [vomiting]
  • The vomitus should never contain bile in this condition.

Signs — what you find (3)

  • A firm, egg-shaped, non-tender mass can usually be felt in the upper right part of the abdomen.
  • Visible waves of reverse peristalsis may cross the abdomen during exam.
  • Dehydration shows up as sunken fontanelles, dry mouth, reduced tearing, poor skin turgor, and lethargy. [dehydration · dry mouth · lethargy]

Tests (6)

  • The characteristic electrolyte pattern is low chloride and potassium with a metabolic alkalosis.
  • Because ultrasound now catches cases earlier, that electrolyte pattern shows up in under half of infants.
  • Ultrasound is the standard test for this diagnosis, valued for being reliable and easy to perform.
  • A muscle wall of at least 3 mm and a channel at least 15 mm long on ultrasound are the abnormal cutoffs.
  • A contrast swallow study is an option when ultrasound is unclear, though it is rarely required.
  • A plain abdominal X-ray does not reliably confirm or exclude the condition.

If not this — what else fits (2)

  • Bilious vomiting in the first weeks of life, unlike the non-bilious pattern here, points to malrotation with volvulus, seen as a corkscrew bowel on contrast imaging.
  • Gastroenteritis, kidney failure, sepsis, hernia, and several other neonatal causes of vomiting are also on the list.

SourceStatPearls "Pyloric Stenosis" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)

1st line
Adult dose and duration

Presents at roughly three to six weeks of age with projectile non-bilious vomiting and a palpable 'olive' mass; this is a surgical condition (pyloromyotomy after hospital correction of fluid/electrolytes) with no outpatient drug treatment. - Refer

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Presents at roughly three to six weeks of age with projectile non-bilious vomiting and a palpable 'olive' mass; this is a surgical condition (pyloromyotomy after hospital correction of fluid/electrolytes) with no outpatient drug treatment.

Cautions
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Delayed diagnosis of pyloric stenosis can lead to severe dehydration and hypovolemic shock.
  • RED FLAG - Severe vomiting in pyloric stenosis causes classic hypochloremic, hypokalemic metabolic alkalosis requiring IV fluid and electrolyte correction.
  • RED FLAG - Persistent vomiting with poor weight gain, dehydration, visible peristaltic waves, or lethargy.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.