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Question |
7m female infant present with sever vomiting since 4m s.t.projectile .previous 2 deaths in the infantile age without definite dx. On exam. FTTill looking infant dehydrated . vital data are normal.CVS& chest are normal.Abdominal exam. reveal hepatosplenomegaly,no mass.Barium study is suggestive of pyloric stenosis.Surgery was performed.No clear olive was found but just mild thickening which splitted.The liver was enlarged,yellowish not smooth with gritty sensation.Mild bleeding occur from the wound.Questions; 1.Was the surgery mandatory? 2.what is the real dx? 3.What is the mangment? ?
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Answer |
ONe needs to know the blood gases whether there was metabolic acidosis or alkalosis in the first place. Also what are the liver function tests? And what is the serum electroytes. One needs to keep on mind conditions such as :
RTA
Barter's syndrome
CAH
Inborn error of metabolism
apart from pyloric stenosis.
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