What is the most-likely diagnosis of a 26 day old infant presenting with recurrent nonbilious vomiting with constipation and loss of weight?
High-Yield Explanation
Ans. (d) Pyloric stenosisRef: Nelson 18th ed.l Ch. 326.1* All babies REGURGITATE curdled milk. So the mother is instructed to always put the baby to shoulder after breast feeding the child as this shall help the child burp and expel the swallowed air.* However if a male infant , first born , 2-3 weeks old is brought to your clinic with recurrent vomiting which is non-bilious and associated with failure to gain weight, then suspect-HYPERTROHPIC PYLORIC STENOSIS* A lump may be palpable to gentle examination in the epigastrium with finding of visible peristalsis. The investigation of choice shall be USG abdomen. Surgery to be done shall be a pyloromyotomy (Ramstedt operation).Previous year question on pediatric gastro-enterology* Hypokalemic hypochloremic metabolic alkalosis is seen in = Hypertrophic pyloric stenosis* Hyperkalemic hyperchloremic metabolic acidosis is seen in= Uretero-sigmoidostomy* MC cause of hematochezia in a preterm neonate= Necrotizing Enterocolitis* MC cause of hematochezia in children= Rectal Prolapse> Meckel's Diverticulum* Double bubble sign= duodenal atresia* Inverto-gram(Special X ray of the baby in inverted position)isused for = Ano-rectal malformations