Thursday, September 4, 2008

Happy 40th Birthday to my brother

My baby brother turns 40 today!    He inadvertently taught me my first surgical lesson.  As a 5-6 week old infant, he began having projectile vomiting.  When you have seen "projectile vomiting", you never forget it.  It is not the little bit of drool with a burp.  It is not just upchucking on your shirt.  It is literally projected across the room. (photo credit)

I don't know if he had  a palpable "olive" (a firm, nontender, and mobile hard pylorus that is 1-2 cm in diameter) on physical exam.  He was always hungry and wanted to eat, but it all came back up almost immediately.  His is a diagnosis (pyloric stenosis) and exam I was good at in medical school and residency.

He had an open pyloromyotomy (pie-lore-oh-my-ot-toe-me)  and in no time began to thrive.  He now has a very small scar from that surgery.  He is 6'5" tall and weighs about 250 lb and other than his high blood pressure  he is fairly healthy.

 

Happy Birthday Baby Brother!  Hope you have many, many more.

 

For more information on pyloric stenosis:

Pediatrics, Pyloric Stenosis; eMedicine Article, Jan 22, 2008; Jagvir Singh MD, Dara Kass MD, and Richard Sinert DO

Pyloric Stenosis; American Pediatric Surgical Association (has a video of the pyloromyotomy procedure)

Pyloric Stenosis -- Mayo Clinic Article

1 comment:

Dreaming again said...

On of the many issues Benjamin had at birth was Pyloric Spasm. His first projectile vomiting was his second feeding.

He was hospitalized at 2 weeks old with pnemonia and failure to thrive after having been born at 9 lbs 8 3/4 oz. and loosing down to 8 lbs 1 oz. (nurses kept going this great big 8 lb baby is failure to thrive?)

It is scary to have a baby born too big to wear the new born clothes, fit into them at 2 weeks, and have them baggy at 3 weeks.

He wound up also having protein intolerance ...so we were off to the pre digested forumula routes ...

He had slight pyloric stenosis, but not enough to justify the risk of surgery with other health issues going on. The spasms seemed to be the worst of the issue, along with the protein intolerance.

So, now at 16 ... it still exists ... it's a joke now in our family. It's 98% controlled but that 2% .. you do not want to see!