Master Hypertrophic Pyloric Stenosis (HPS) Interventions with Picmonic for Medicine

Pyloromyotomy is the standard of treatment and has excellent outcomes. It involves the surgeon cutting through the muscle fibers of the pyloris. This relieves the pyloric contraction, which was obstructing flow of gastric contents to the duodenum.

It is important to stabilize the hydration status and monitor intake and output of the newborn. Furthermore, the fluid and electrolyte imbalances should be corrected and you should administer fluids intravenously (as prescribed) for rehydration. This includes correcting metabolic alkalosis, which can develop from repeated vomiting.

Often, if the newborn has excessive vomiting, an NG tube will be placed to decompress the stomach and relieve its contents.

Preoperatively, you should monitor feeding and observe if vomiting occurs. Depending on how far out from surgery the newborn is, they may be prescribed to be NPO.

Postoperatively, you should begin small, frequent feedings as prescribed. Mothers may begin formula feedings or breastfeeding within 24 hours of pyloromyotomy.

Gradually, the amount and intervals of feeding should increase. It is recommended that feedings occur every 4-6 hours, and these feedings should include glucose, water, or electrolyte solution. The infant should be fed slowly, burped frequently and the infant should be handled minimally after feedings.

The parents should be educated that within 2 days, the infant should have full feeding. This diet should be maintained, and the infant should be monitored for abdominal distention.