Vomiting and Pyloric Stenosis in Infancy

What this deck covers

Vomiting and Pyloric Stenosis in Infancy in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Hungry after every vomit
2. Alkalotic, with acid urine
3. Theatre, but not yet
4. Confirming the diagnosis
5. Waves and an olive
6. Green vomit on day three
7. A flexure on the wrong side
8. Two bubbles, nothing beyond
9. Pain in waves, pale between
10. The bottle is too big
11. Vomiting, blood and eczema
12. Vomiting and a growing head
13. Vomiting with the wrong potassium
14. Dehydrated but drinking
15. Fever, vomiting, no focus
16. Vomiting and shocked
17. Vomiting after the operation
18. Attacks, then perfectly well

What it teaches

• Separating the forceful, hungry vomiting of gastric outlet obstruction from the effortless posseting of a thriving infant.
• The hypochloraemic, hypokalaemic alkalosis of pyloric stenosis, why the urine is paradoxically acidic, and why it is corrected before theatre.
• Bilious vomiting in a newborn as a surgical emergency, and the contrast findings that confirm malrotation with volvulus.
• The medical mimics that are missed: adrenal crisis, urinary infection, raised intracranial pressure and cow’s milk protein allergy.