The child with pyloric stenosis usually presents at 3 to 4 weeks of age. In rare instances symptoms may be present at or soon after birth, but this condition rarely presents for the first time in infants over the age of 12 weeks.
The classic symptom of this condition is projectile vomiting. The vomitus does not contain bile and the child remains hungry and takes food immediately after vomiting.
There is a failure to gain weight and, as a result of dehydration, the baby is generally constipated with the stools resembling the faecal pellets of a rabbit. Note though that constipation is not always a feature of a child presenting with infantile pyloric stenosis.
The infant may be dehydrated with visible peristalsis of the dilated stomach in the epigastrium. 95% have a palpable pyloric mass (shape and size of an olive) which is felt in the right upper abdomen, especially after vomiting. A few cases will present with haematemesis.
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