Clinical features

The clinical features of adult pyloric stenosis include:

• characteristic profuse vomiting, free from bile, but may contain food eaten one or two days previously
• copious vomiting may cause associated:
  • loss of weight
  • constipation - because of dehydration
  • weakness due to electrolyte disturbance

On examination, the patient may appear dehydrated and wasted. The progressive dilatation and hypertrophy of the stomach can be summed up as 'the stomach you can hear, the stomach you can hear and see, and the stomach you can hear, see and feel'.

At first a gastric splash can be elicited by shaking the patient's abdomen several hours after a meal; as the stomach enlarges, visible peristalsis also can be seen, passing from left to right across the upper abdomen. Finally, the grossly dilated, hypertrophied stomach - full of stale food and fluid, can actually be palpated.