Pyloromyotomy

About Pyloromyotomy

Pyloromyotomy is the standard operation for infantile hypertrophic pyloric stenosis, a condition in which the muscle of the pylorus, the outlet of the stomach, thickens and blocks the passage of milk into the intestine. It typically affects infants in the first weeks of life, is more common in boys, and causes forceful projectile vomiting. Diagnosis is usually made with ultrasound. Before surgery, dehydration and the characteristic salt and acid base disturbances are corrected, since the condition itself is not an immediate surgical emergency. In the operation the surgeon cuts lengthwise through the thickened muscle down to the inner lining without opening it, allowing the lining to bulge through and relieving the obstruction. The technique was described by the German surgeon Conrad Ramstedt in the early twentieth century and is often called the Ramstedt procedure. It can be performed through a small incision at the umbilicus or the right upper abdomen, or laparoscopically. The operation is one of the most common abdominal operations in infancy.