A male infant is brought into the clinic because of colic-like symptoms. The mother states he acts like something is hurting. After eating, he vomits most of the feeding and then assumes a fetal position
He is also not gaining weight. The nurse practitioner is thinking that he is displaying clinical manifestations of obstruction and may have which of the following medical diagnoses?
A)
Duodenal ulceration
B)
Constipation
C)
Pyloric stenosis
D)
Erosive esophagitis
Ans:
C
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An example of obstruction is hypertrophic pyloric stenosis, which can occur in infants with an abnormally thick muscularis layer in the terminal pylorus. A defect in the lining of the first part of the small intestine (duodenal ulcer) is usually caused by an infection with a bacterium (germ) called H. pylori. When food is ingested and digested but not excreted, it forms a blockage in the colon. Regular bowel movements are needed in order for this not to occur. When bowel movements are irregular, constipation may result. This infant appears to be vomiting his stomach content; therefore, no BM is occurring since no food is being digested in the small intestine. Gastrin provides the major stimulus for gastric acid production. Its action on the lower esophageal sphincter protects the esophageal mucosa when gastric acid levels are elevated. If stomach acids reflux into the esophagus, acid irritation and inflammation cause extensive injuries to the esophagus.
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