Sakshi rathod

Group 627

Case 4

3 month old baby boy

Weight-3.2 kg

Main complaint:-
 No gain of weight and weight loss since birth
 Recurrent vomiting- non bilious
 Dehydration
 Kidney injuries at 1 month
 Malnutrition 4 grade

History :-
 Age of 3 week babystartes vomiting 10-12 epi a day continue vomiting till11 days andanuria
5 daywith severe dehydration

Physical examination :-
 Malnutrition grade 4
 Passing urine adequately
 Loss 900g due to vomiting since 3 week ,current weight is 2.3kg
 Pulse are pulpable

examination results :-
 Pulse rate 110/min
 Bp-80/50
 Rr-35/min
 Ph-7.7 (low)( metabolic alkalosis)
 High bicarbonate 35.1mg/L(M.A)
 Sodium-121meq/L (hyponatremia) (low)
 Potassium-2.74meq/L (hypokalemia) (low)
 Chloride-64meq/L (low)
 Hemoglobin- 9mg/dl (low) (anemia)
 ALT-AST- 127/L- 107/L (high )
 Total protein-7.7 mg/dl(abnormal)
 Ultrasound-pylorusand distended stomach

Objective examination:-
 Cbc
 Urine analysis
 Ultrasound

Confirm diagnosis:-
Pyloric stenosis

Treatment:-
 Atropine sulphate IV – 0.02-0.5 mg/kg
 Surgery- pyloroplasty