The mother of the 7-week-old infant reports the baby has had fewer and fewer wet diapers and hasn’t stooled in 3 days despite having a ravenous appetite. The mother reports that the child has been vomiting with increasing force and volume over the past two weeks. The emesis just appears to be partially digested breastmilk and fluid. The infant appears well and vitals are normal. Upon palpation of the abdomen, a small, olive-shaped mass is appreciated. The nurse alerts the provider and prepares education for which procedure?

Question

The mother of the 7-week-old infant reports the baby has had fewer and fewer wet diapers and hasn&rsquo;t stooled in 3 days despite having a ravenous appetite. The mother reports that the child has been vomiting with increasing force and volume over the past two weeks. The emesis just appears to be partially digested breastmilk and fluid. The infant appears well and vitals are normal. Upon palpation of the abdomen, a small, olive-shaped mass is appreciated. The nurse alerts the provider and prepares education for which procedure?

Accepted Answer

Pyloromyotomy. Projectile vomiting and an olive-shaped abdominal mass indicates pyloric stenosis. It is diagnosed based on clinical exam and history, so further evaluation (upper GI study) is unnecessary. It is treated by a pyloromyotomy. A barium enema is used to evaluate intestinal conditions. An exploratory laparotomy would be appropriate if the emesis was bilious in nature or the child appears ill.

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