Question
Consider the following features:
1. Visible gastric peristalsis
2. Bilious vomiting
3. Palpable tumour
4. Melena
Which of these is/are feature/features of infantile hypertrophic pyloric stenosis?
The correct answer is
1 and 3 only
Identifying Pyloric Stenosis Features
This solution identifies the characteristic signs of infantile hypertrophic pyloric stenosis (IHPS) from the given list.
Feature Analysis for IHPS
- 1. Visible gastric peristalsis: This is a classic sign of IHPS. The hypertrophied pyloric muscle obstructs food passage, causing forceful stomach contractions that can be seen as waves moving across the baby's abdomen.
- 2. Bilious vomiting: IHPS typically causes non-bilious projectile vomiting. Vomit containing bile (bilious) indicates an obstruction located further down the digestive tract, below the entry of the bile duct into the duodenum.
- 3. Palpable tumour: A small, firm mass, often described as an "olive," can frequently be felt in the upper right quadrant of the abdomen. This mass is the thickened pyloric muscle and is a key diagnostic finding for IHPS.
- 4. Melena: Melena (dark, tarry stools) signifies bleeding from the upper gastrointestinal tract. It is not a typical symptom directly associated with IHPS itself, although severe vomiting could potentially cause minor mucosal irritation.
Conclusion on IHPS Signs
Based on the clinical presentation of IHPS, the most significant and characteristic features are visible gastric peristalsis (1) and a palpable pyloric tumour (3).
Therefore, features 1 and 3 are the correct indicators of infantile hypertrophic pyloric stenosis.
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