Congenital hypertrophic pyloric stenosis (CHPS) is a condition where the circular muscle of the pylorus becomes thickened, causing a narrowing of the pyloric channel. It most commonly affects firstborn male infants around one month of age, presenting with projectile vomiting, feeding intolerance, and signs of dehydration. Ultrasound is the gold standard for diagnosis, showing pyloric wall thickening over 3.5mm and elongation over 15mm. Surgical pyloromyotomy is required to correct the narrowing, after which feeds can resume within 6 hours with no long term complications.

2. Congenital hypertrophic
pyloric stenosis (CHPS)
Misnomer

3. •Idiopathic
•Genetic & Environmental factors

4. Hypertrophy of the circular muscle of
the pylorus( dueodenem is normal)

5.  First born male child
 Males 4:1
 Onset at 2-8 weeks of age, commonly at
around one month of age

9.  Coffee ground vomitus due to associated
gastritis
 Starvation stools
 Dehydration & weight loss

10. Ultrasound abdomen
 to look for the thickened >3.5mm and
elongated>15mm pylorus(doughnut sign)
 Gold standard at present, but needs an
experienced sonologist

11. Elongated narrow pyloric channel

12.  Hypochloremic hypokalemic metabolic
alkalosis
 Dehydration, alkalosis & electrolytes to be
corrected prior to surgery – may take upto 24
hours
 Fluid - 5% dextrose in 0.45 normal saline
containing 20 to 40 mEq/L of potassium

14.  Feeds can be started as soon as 6 hours post
operatively
 No long term complications
 ( 2 cm transverse incison after identifyin
prepylric vein. wound infetion wound dehisene
h’ge duod perforation (s urg complications)