If the regurgitations of toddlers are frequent, benign and do not require any special treatment, vomiting occurring after each meal and accompanied by rapid weight loss should alert. They are probably due to pyloric stenosis and only surgery can remedy this malformation.

A congenital malformation of the digestive tract, hypertrophic pyloric stenosis affects approximately 2 in 1000 infants, the vast majority of whom are boys. It is explained by a narrowing of the pyloric canal (or pyloric ring), itself due to the thickening of the muscle that surrounds it. Making the junction between the bottom of the stomach and the duodenum, that is to say the upper part of the small intestine, the pyloric duct normally ensures good emptying of the stomach. But when the caliber is reduced, the stomach can no longer empty normally from the bottom and empties violently from the top, resulting in profuse vomiting.

Pyloric stenosis first manifests with regurgitation that begins around 3-4 weeks. But unlike the physiological regurgitation of the infant, due to the immaturity of his digestive system and his liquid diet, which will gradually decrease over time, these regurgitations worsen over the days until they become jet vomiting. demonstrating after every meal. Often accompanied by constipation, this abundant systematic vomiting quickly causes the infant to lose weight, who nevertheless retains a good appetite.

The occurrence of these symptoms requires immediate medical advice. In 95% of cases, an ultrasound is sufficient to confirm the diagnosis of pyloric stenosis. However, it is sometimes necessary to accompany it with more in-depth examinations (blood test, opacification of the digestive tract by ingestion of a contrast product).

The exact causes of this malformation are not well known, but we know that there are hereditary and genetic factors: an infant is more likely to be affected if his parents themselves have suffered from pyloric stenosis. It would also seem that the first of the siblings are more often concerned.

Pyloric stenosis is a benign condition if diagnosed early and treated early. Otherwise, the malnutrition of the infant worsens to have fatal consequences.

Performed under general anesthesia, pyloric stenosis surgery is today an extremely well-established procedure lasting between 15 and 30 minutes. After making a small incision at the level of the infant’s navel, the surgeon extracts the pylorus from the abdomen and cuts the enlarged muscle that surrounds it in its length to end its excessive compression and make it possible again to pass the contents. from the stomach to the intestine. After making sure that he has not punctured the digestive tract, this is a rare but possible complication, the surgeon then reinserts the pylorus into the abdomen before suturing the wound. The young person who has been operated on will only keep from the operation a very small scar above the navel. He may suffer from regurgitation during the days following the operation but everything will return to order very quickly and he will not keep any after-effects.