# Infantile pyloric stenosis

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- 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 date: 2026-08

## Verified against

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

## Treatment metadata

- No drug therapy in primary care (Recognition & Referral)

## Complete treatment card

```text
INFANTILE PYLORIC STENOSIS
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/
Review status: REVIEWED against No dose - referral pathway, no medicine given in primary care,
               Infantile pyloric stenosis - disease-level clinical article
               (pyloric-stenosis-clinical.txt)  (2026-08)

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.
  Source  StatPearls "Pyloric Stenosis" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)[1st line]
   Adult    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
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   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.
   Caution  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.
```

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