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Lahey Health is now part of Beth Israel Lahey Health

by EBSCO Medical Review Board
(Pyloric Stenosis Repair; Pyloromyotomy)

Definition

Pyloroplasty is surgery to make the pylorus opening wider. The pylorus is the opening between the stomach and the intestines.

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Reasons for Procedure

The pylorus opens and closes to allow food to pass to the intestines. A problem called pyloric stenosis can make this area thicker. This can make it hard for food to pass. This surgery is done to widen the opening.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Damage to intestines
  • Hernia formation at the incision site

Things that may raise the risk of problems are:

  • Chronic diseases, such as heart or lung problems
  • Prior abdominal surgeries
  • Malnutrition or dehydration

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies your child may have
  • Current medicines, herbs, and supplements that your child takes and whether they need to be stopped before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before

Anesthesia

General anesthesia will be given. Your child will be asleep.

Description of Procedure

Several small incisions will be made in the abdomen. Surgical tools will be inserted through these incisions. An incision will be made in the muscle of the pylorus. The pylorus will then be sewn back together in a wider shape. The incisions will be closed with stitches or staples. A bandage will be placed over the area.

This procedure may also be done as an open procedure. This uses a larger incision.

How Long Will It Take?

1 to 2 hours

Will It Hurt?

Pain and swelling are common in the first week. Medicine and home care can help.

Average Hospital Stay

The usual length of stay is 1 to 3 days. If your child has any problems, they may need to stay longer.

Post-procedure Care

At the Hospital

Right after the procedure, the staff may:

  • Give pain medicine
  • Gradually introduce your child to a normal diet

During your child's stay, the hospital staff will take steps to lower your child's risk of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your child's incisions covered

There are also steps you can take to lower your child's risk of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your child's incisions
At Home

It will take a few weeks for the incisions and muscles to fully heal. Physical activity may need to be limited during this time. Your child may need help with daily activites and delay their return to school.

Call Your Child's Doctor

Call the doctor if your child is not getting better or has:

  • Signs of infection, such as fever and chills
  • Redness, swelling, excessive bleeding, or any discharge from the incision site
  • Pain that cannot be controlled with medicine
  • Severe belly pain
  • Been vomiting blood
  • Dark-colored, tarry stools or blood in the stool

If you think your child has an emergency, call for medical help right away.

RESOURCES

American College of Gastroenterology  http://gi.org 

Family Doctor—American Academy of Family Physicians  https://familydoctor.org 

CANADIAN RESOURCES

Canadian Association of Gastroenterology  https://www.cag-acg.org 

Health Canada  https://www.canada.ca 

References

Hypertrophic pyloric stenosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hypertrophic-pyloric-stenosis. Accessed September 8, 2021.

Hypertrophic pyloric stenosis. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/pediatrics/gastrointestinal-disorders-in-neonates-and-infants/hypertrophic-pyloric-stenosis. Accessed September 8, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Kari Kuenn, MD
  • Review Date: 07/2021
  • Update Date: 09/08/2021