Question:medium
An abdominal mass is best demonstrated in congenital hypertrophic pyloric stenosis by:
An abdominal mass is best demonstrated in congenital hypertrophic pyloric stenosis by:
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The olive-shaped pyloric mass is felt best when the baby is relaxed and feeding - the test feed.
Updated On: Jun 23, 2026
- In palpation over the epigastrium
- In left hypochondriac region
- Right iliac fossa
- During feeding
Show Solution
The Correct Option is D
Solution and Explanation
Step 1: Picture the infant with projectile milk vomiting who stays hungry - the classic story of infantile hypertrophic pyloric stenosis, where the thickened pylorus forms a palpable lump.
Step 2: The trick to feeling that lump is the $test$ $feed$. Giving the baby a bottle relaxes the abdominal wall and fills the stomach, and it is precisely during feeding that the pyloric olive is best felt and gastric peristalsis is seen.
Step 3: Anatomically the olive-shaped mass lies in the right upper quadrant, and waves of peristalsis sweep from left to right across the upper abdomen as the stomach struggles to empty past the obstruction.
Step 4: Simply pressing on the epigastrium, left hypochondrium or right iliac fossa in a crying, tense baby usually fails. The reliable demonstration happens during feeding, after which ultrasound confirms the thickened muscle.
\[\boxed{\text{During feeding}}\]
Step 2: The trick to feeling that lump is the $test$ $feed$. Giving the baby a bottle relaxes the abdominal wall and fills the stomach, and it is precisely during feeding that the pyloric olive is best felt and gastric peristalsis is seen.
Step 3: Anatomically the olive-shaped mass lies in the right upper quadrant, and waves of peristalsis sweep from left to right across the upper abdomen as the stomach struggles to empty past the obstruction.
Step 4: Simply pressing on the epigastrium, left hypochondrium or right iliac fossa in a crying, tense baby usually fails. The reliable demonstration happens during feeding, after which ultrasound confirms the thickened muscle.
\[\boxed{\text{During feeding}}\]
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