Pyloric stenosis is classically associated with which finding?

Pyloric stenosis is classically associated with which finding?

• A. Olive-shaped mass
• B. Abdominal distension
• C. Projectile vomiting
• D. Hepatomegaly

Answer: (C)

Pyloric stenosis presents with obstruction of the gastric outlet, so the hallmark symptom is nonbilious, forceful projectile vomiting after feeds. The vomiting occurs because the narrowed pylorus resists passage of gastric contents, and the strong peristaltic waves push the contents through despite the obstruction. This classic presentation often leads to dehydration and a metabolic picture of hypochloremic, hypokalemic metabolic alkalosis due to loss of gastric acid. A palpable olive-shaped pyloric mass can be a distinctive physical finding, and many exams emphasize it as a key sign. However, it isn’t always easy to detect—especially in young or smaller infants—whereas the projectile vomiting is a universal and prominent feature that patients consistently exhibit. The other options—abdominal distension or hepatomegaly—are not characteristic findings of this condition.

Pyloric stenosis presents with obstruction of the gastric outlet, so the hallmark symptom is nonbilious, forceful projectile vomiting after feeds. The vomiting occurs because the narrowed pylorus resists passage of gastric contents, and the strong peristaltic waves push the contents through despite the obstruction. This classic presentation often leads to dehydration and a metabolic picture of hypochloremic, hypokalemic metabolic alkalosis due to loss of gastric acid.

A palpable olive-shaped pyloric mass can be a distinctive physical finding, and many exams emphasize it as a key sign. However, it isn’t always easy to detect—especially in young or smaller infants—whereas the projectile vomiting is a universal and prominent feature that patients consistently exhibit. The other options—abdominal distension or hepatomegaly—are not characteristic findings of this condition.