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Hypertrophic pyloric stenosis — MCCQE Part 1 MCQ

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EasyNausea/VomitingHypertrophic pyloric stenosisMCCQE Part 1

A 5-week-old boy has progressive non-bilious projectile vomiting after feeds and remains hungry. He has hypochloraemic metabolic alkalosis. Which of the following is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Hypertrophic pyloric stenosis

Projectile non-bilious vomiting in a hungry 2-8 week infant with hypochloraemic alkalosis is classic hypertrophic pyloric stenosis. Bilious vomiting would suggest malrotation with volvulus and is a surgical emergency. Management includes correcting dehydration/electrolytes before pyloromyotomy.

Reference: Canadian Paediatric Society/pediatric surgery practice