Division of Pediatric Surgery, Cohen Children's Medical Center, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY.
Pediatr Rev. 2021 Oct;42(10):539-545. doi: 10.1542/pir.2020-003277.
Hypertrophic pyloric stenosis is a common condition seen in the first 1 to 3 months after birth. Patients typically present with nonbilious projectile emesis after feeds that may result in hypokalemic, hypochloremic metabolic alkalosis. Although inability to tolerate feeds is frequently seen with self-limited conditions such as reflux, a low threshold to obtain an ultrasonographic image is important to prevent a delay in diagnosis. Although operative intervention is the treatment, it is imperative that patients are hydrated and serum electrolyte concentrations normalized before the induction of anesthesia. Laparoscopic pyloromyotomy is safe and effective. Postoperative emesis is normal, and reassurance to parents is appropriate. There is no significant long-term physiologic impairment from pyloric stenosis after successful surgical intervention.
肥厚性幽门狭窄是一种常见于出生后 1 至 3 个月的疾病。患者通常在进食后出现非胆汁性喷射性呕吐，可能导致低钾血症、低氯血症代谢性碱中毒。虽然不能耐受喂养是常见的自限性疾病，如反流，但获得超声图像的门槛较低对于防止诊断延误很重要。虽然手术干预是治疗方法，但在诱导麻醉前确保患者补液和血清电解质浓度正常至关重要。腹腔镜幽门肌切开术是安全有效的。术后呕吐是正常的，应向家长提供适当的安慰。成功的手术干预后，肥厚性幽门狭窄不会对生理功能造成显著的长期损害。
