Pyloric stenosis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Palpation of the abdomen may reveal a mass in the epigastrium. This mass consists of the enlarged pylorus smooth muscle and it is called olive. Palpation of a hypertrophied pylorus is very useful in diagnosis of hypertrophic pyloric stenosis.Peristaltic waves may be palpated or may be seen in abdominal exam of patients with infantile pyloric stenosis. Hypothermia and tachycardia with regular pulse and tachypnea may be present. In skin examination cyanosis, poor skin turgur, jaundice and pallor may be present.

The presence of palpation of an abdominal mass and visible peristalsis on physical examination is diagnostic of infantile pyloric stenosis.

• Hypothermia may be present^[1]
• Tachycardia with regular pulse may be present due to dehydration
• Tachypnea may be present due to dehydration

• Cyanosis may be present due to dehydration

• Poor skin turgor may be present due to dehydration

• Jaundice may be present

• Depressed fontanelles may be present due to dehydration
• Decereased tearing may be present due to dehydration

Physical examination of neck is usually normal.

Physical examination of lungs is usually normal.

Physical examination of heart is usually normal.

• Palpation of the abdomen may reveal a mass in the epigastrium.
• This mass consists of the enlarged pylorus smooth muscle and it is called olive.^[2]
• Palpation of a hypertrophied pylorus is very useful in diagnosis of hypertrophic pyloric stenosis.^[3]
• Peristaltic waves may be palpated or may be seen in abdominal exam of patients with infantile pyloric stenosis.^[4]

Physical examination of back is usually normal.

Physical examination of genitourinary system is usually normal.

Physical examination of neuromuscular system is usually normal.

Physical examination of extremities is usually normal.

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