Pyloric stenosis
18 topics in this forum
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[size=20px]A 5-week old infant presents with a six-day history of projectile nonbilious emesis. He is awake and responsive. His mother has noticed only one wet diaper in the last 24 hours. On exam the anterior fontanel is sunken. Electrolytes are sodium 136, potassium of 3.5, chloride 92, CO2 32. Following a normal saline bolus of 20 mL/kg, the most appropriate maintenance fluid for this patient with possible hypertrophic pyloric stenosis is: A D10 W with 20 mEq/L potassium chloride B D10 0.2% saline C D5 0.9% (normal) saline D D5 0.45% sodium chloride with 20 mEq/L of potassium chloride [/size]
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[center]Open Pyloromyotomy: Transverse Incision. (Infantile Hypertrophic Pyloric Stenosis) see in next post[/center]
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In treatment of hypokalemic Hypochloremic metabolic alkalosis , in cases of infantile pyloric stenosis [center][/center]
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A practical approach to the volume of resuscitation is suggested by Dalton et al. Resuscitation is based on serum chloride, where Cl < 85 mmol/kg —3 boluses of 20 ml/kg NS and Cl < 97mmol/kg—2 boluses of 20 ml/kg NS, gets to metabolic readiness for surgery, avoiding multiple blood draws.
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[center]Open Pyloromyotomy (Bianchi Supra-umbilical) approach. Dr Tamer Ashraf Wafa , Dr Amr Elsaeed see in next post[/center]
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[center][/center]
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see video link in second post
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see video link in second post
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Regarding the recent systematic reviews comparing outcomes for laparoscopic vs open pyloromyotomy, These studies showed that the laparoscopic approach was associated with: A Reduced operative time B Increased risk of surgical site infection C Increased risk of incomplete myotomy D Reduced risk of mucosal perforation
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see video link in second post
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see video link in second post
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Any one want a high quality PDF of this chart, post in this thread and use a personalized picture as an avatar, I will send it to you in a private message Edit: available without restrictions
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[center]Laparoscopic pyloromyotomy. See video in 2nd post[/center]
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Saudi pediatric Surgery board lectures, download from next post
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