A 9-month old girl with Trisomy 21 presents with acute non bilious emesis, worsening over 5 days. She has a history of intermittent vomiting and poor weight gain since birth, diagnosed and treated as gastro-esophageal reflux disease. Exam shows a deyhdrated, but non-toxic baby weighing 5.4 kg (15th percentile). Her abdomen is soft and non-tender. Laboratory tests show a severe hypokalemic hypochloremic metabolic alkalosis and hemoconcentration. A films is shown below. How would you proceed with this patient?

 

https://www.dropbox.com/scl/fi/o7xurlfyacrcoai9rpj9i/CBCLIPS-Episode-48.mp4?rlkey=nk4iwjxd86z8xivhoes4am8f6&dl=0