Dawaa Reference

chronic

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.