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December 1957

Preoperative and Postoperative Care of Congenital Pyloric Stenosis

Author Affiliations

From the Departments of Surgery and Pediatrics, the Children's Hospital, of Harper Hospital, and Wayne State University College of Medicine.

AMA Arch Surg. 1957;75(6):877-879. doi:10.1001/archsurg.1957.01280180009002

Once the diagnosis of congenital hypertrophy pyloric stenosis has been definitely established by a history of projectile vomiting with palpation of the pyloric tumor by an experienced clinician, or if no tumor is palpated but an upper gastrointestinal series demonstrates the typical string sign and an elongated pyloric canal with gastric retention of barium, the main consideration is the preparation of the infant for the Fredet-Ramstedt operation. All these patients demonstrate a varying degree of dehydration, weight loss, and metabolic alkalosis, which need correction prior to surgical intervention. Only when an adequate formula can be taken by mouth and absorbed will the infant be able to replace the protoplasm he has lost and begin to grow.

The aim of preoperative treatment is to restore as quickly, but as safely, as possible most of the accumulated electrolyte and water losses; to ensure sufficient hemoglobin and protein content of the blood; to