A Case of Persistent Vomiting

Q- A 2-week-old boy is brought for persistent vomiting of non-bilious material after feeding. The boy is lysergic and dehydrated. Examination reveals presence of an olive-sized mass in the epigastric area moving with peristalsis.

What is the most likely diagnosis?

A- Duodenal atresia

B- Esophageal atresia

C- Meckel’s diverticulum

D- Pyloric stenosis

D- Pyloric stenosis- A and C cause similar symptoms but the vomiting would be bilious. B doesn’t show olive-sized mass which is characteristic of pyloric stenosis.

Q- Which of the following is the substance released from the parietal cells of the stomach?

A- Gastrin

B- Hydrochloric acid

C- Mucus

D- Pepsinogen

B- Hydrochloric acid- A is secreted by G cells, C is secreted by goblet cells while D is secreted by chief cells of the stomach.

Q- Which of the following tests is diagnostic in case of a 2-week old boy with persistent vomiting of non-bilious material after feeding?

A- Abdominal ultrasound

B- Barium studies

C- Chest x-ray

D- Esophagostomy

A- Abdominal ultrasound- Hypertrophic pylorus is diagnostic of pyloric stenosis. Other tests are not recommended at this age or not diagnostic of this case.

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