Approach to vomiting (newborn and infant) Quiz: Ace Your Exams
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A 5-week-old boy is brought to the emergency department for evaluation of multiple episodes of non-bloody nonbilious projectile emesis. The parents report the patient has always spit up, but the volume, frequency, and intensity of spit-up has increased significantly over the past week, and it has become projectile. The patient immediately vomits after feeding and is always hungry. He has only gained 12 grams/day. He has an appropriate frequency of wet diapers. Temperature is 36.8°C (98.2°F), pulse is 152/min, blood pressure is 78/48 mm Hg, respirations are 36/min, and oxygen saturation is 100% on room air. On physical examination, the anterior fontanelle is open and flat. Cardiopulmonary examination is normal. The abdomen appears slightly distended and an “olive-like” mass is palpated in the upper right quadrant. Abdominal ultrasound confirms the presumed diagnosis by identifying a thickened pyloric sphincter (4mm). Which of the following is most strongly associated with this patient’s underlying condition?
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