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Pyloric stenosis — RACP Paediatrics MCQ

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EasyGastroenterologyPyloric stenosisRACP Paediatrics

A 5-week-old boy has progressively forceful non-bilious vomiting after feeds and remains hungry afterwards. He has lost weight and blood tests show hypochloraemic metabolic alkalosis. What is the most likely diagnosis?

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Correct answer: E — Hypertrophic pyloric stenosis

Progressive projectile non-bilious vomiting, persistent hunger and hypochloraemic metabolic alkalosis strongly suggest hypertrophic pyloric stenosis. Malrotation with volvulus is more likely with bilious vomiting and acute instability. Ultrasound confirms the diagnosis after hydration and electrolytes are addressed.

Reference: RCH Vomiting guideline; RACP Knowledge Guides