Pilorospazm

Pilorospazm is a disease common in newborns and children of the first months of life and is characterized by frequent periodic vomiting. Due, perhaps, functional disorders of innervation of the stomach. An important differential diagnosis with the pyloric stenosis (see), as at pilorospazm conservative treatment, and when pyloric stenosis needs surgery. Differential diagnostic differences of pilorospazm and pyloric stenosis is shown in the table, compiled by N. I. Langevin.
Vomiting with the first days of life also notes with congenital intestinal obstruction, but in these cases in vomitus may be noted admixture of bile. The final diagnosis is established after the x-ray of the gastrointestinal tract with contrast substance.
Treatment of pilorospazm conservative. The great value has the correct feeding, with the addition of concentrated mixtures. Apply the solution of atropine sulfate (1 : 1000) 1 - 2 drops 4-5 times a day, the solution of pipolfen 0,5% 0,2 ml intramuscularly, as well as chlorpromazine (0,025-0,1 g / day, depending on age). When conservative treatment should think about pyloric stenosis or another disease (kardiospazm, diaphragmatic hernia and other).

Differential diagnostic differences of pilorospazm from pyloric stenosis
Signs of pilorospazm Signs pyloric stenosis
Vomiting from birth, frequent Vomiting two weeks of age, rare
The incidence of vomiting varies by day The incidence of vomiting more permanent
Vomiting small amount of vomit Vomiting large quantities of vomit, "the fountain"
Constipation, but sometimes independent chair Almost always sharp constipation
The number mocheispuskani reduced slightly The number mocheispuskani reduced sharply (about 6 per day)
The skin is not very pale Pale skin wrinkling her forehead wrinkles
The motility of the stomach is rare The motility of the stomach is observed frequently, stomach hourglass
Baby screaming The child is more calm
The weight does not change or falls moderately The weight falls sharply
Weight when receiving more than at birth The weight for admission smaller than at birth