What is the role of lab testing in the diagnosis of pediatric pyloric stenosis?

Updated: Nov 13, 2018
  • Author: Sathyaseelan Subramaniam, MD, FAAP; Chief Editor: Kirsten A Bechtel, MD  more...
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  • Electrolytes, pH, BUN, and creatinine levels should be obtained at the same time as intravenous access in patients with pyloric stenosis.
  • Hypochloremic, hypokalemic metabolic alkalosis is the classic electrolyte and acid-base imbalance of pyloric stenosis. This constellation of electrolyte abnormalities is now present in less than 50% of cases given the prompt and timely diagnosis of most infants with pyloric stenosis. However, delayed presentations, or missed cases may lead to persistent emesis. This prolonged vomiting causes progressive loss of fluids rich in hydrochloric acid, which causes the kidneys to retain hydrogen ions in favor of potassium.
  • The dehydration may result in hypernatremia or hyponatremia and may result in prerenal renal failure.
  • Elevated unconjugated bilirubin levels may be present.

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