# Pyloric Stenosis — GCMD Library living collection

Everything in the library about pyloric stenosis — built automatically from dossiers that name it.

Updated: n/a · 3 episodes · 55 cited statements

## Episodes
### Evidence & Research
- [Hot New Topics from The Journal Of Pediatric Surgery: Update Course 2017](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404) — video · 27:37 · [machine version](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404.md)

### Case-Based Learning
- [Pyloric Stenosis with Dr. Alex Bondoc](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728) — podcast · 16:20 · [machine version](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728.md)

### In-Depth Reviews
- [Pyloric Stenosis](https://library.globalcastmd.com/watch/pyloric-stenosis-2532) — video · 12:30 · [machine version](https://library.globalcastmd.com/watch/pyloric-stenosis-2532.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=0) Introduction and Pneumomediastinum Management (Ep 1)
- [6:39](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=399) Pneumomediastinum Discussion and Pyloric Stenosis Introduction (Ep 1)
- [11:16](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=676) Pyloric Stenosis Fluid Resuscitation Protocol (Ep 1)
- [17:20](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=1040) Esophageal Atresia Leak Management (Ep 1)
- [25:04](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=1504) Glycopyrrolate for Anastomotic Leaks (Ep 1)
- [0:19](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=19) Definition, Etiology, and Clinical Presentation of Pyloric Stenosis (Ep 2)
- [1:34](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=94) Differential Diagnosis and Diagnostic Workup (Ep 2)
- [3:06](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=186) Electrolyte Abnormalities and Pathophysiology (Ep 2)
- [4:09](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=249) Resuscitation Protocol and Pre-operative Management (Ep 2)
- [6:05](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=365) Surgical Technique: Pyloromyotomy Steps and Adequacy Assessment (Ep 2)
- [8:39](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=519) Complications and Management of Mucosal Perforation (Ep 2)
- [9:53](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=593) Post-operative Feeding and Management of Persistent Vomiting (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=0) Introduction and Case Presentation (Ep 3)
- [3:05](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=185) Epidemiology and Risk Factors (Ep 3)
- [4:37](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=277) Physical Exam and Diagnostic Workup (Ep 3)
- [6:36](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=396) Medical Management and Stabilization (Ep 3)
- [8:07](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=487) Surgical Technique and Procedure (Ep 3)
- [13:49](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=829) Post-operative Care and Outcomes (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "Pyloric stenosis is hypertrophy and hyperplasia of the inner circular layer with associated mucosal hypertrophy" — Bhargava Muliudi (clinical) [Ep 2 · 0:31](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=31)
- "Pyloric stenosis leads to gastric outlet obstruction in infants between 2 to 10 weeks of age" — Bhargava Muliudi (clinical) [Ep 2 · 0:37](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=37)
- "Pyloric stenosis is more common in males" — Bhargava Muliudi (epidemiological) [Ep 2 · 0:46](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=46)
- "There is increased risk for first born infants with a positive family history" — Bhargava Muliudi (epidemiological) [Ep 2 · 0:49](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=49)
- "Patients with pyloric stenosis typically present with non-bilious vomiting, usually seen between 2 to 10 weeks of life" — Bhargava Muliudi (clinical) [Ep 2 · 1:04](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=64)
- "Infants with pyloric stenosis are otherwise well appearing and hungry after vomiting" — Bhargava Muliudi (clinical) [Ep 2 · 1:12](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=72)
- "Emesis in pyloric stenosis will progress until it is projectile" — Bhargava Muliudi (clinical) [Ep 2 · 1:16](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=76)
- "Hyperbilirubinemia can occur in up to 14% of patients with pyloric stenosis due to downregulation of hepatic enzymes associated with starvation" — Bhargava Muliudi (clinical) [Ep 2 · 1:24](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=84)
- "Bilious emesis should always be worked up to rule out intestinal malrotation with midgut volvulus" — Bhargava Muliudi (guideline) [Ep 2 · 2:00](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=120)
- "Ultrasound is the gold standard for diagnosing pyloric stenosis" — Bhargava Muliudi (clinical) [Ep 2 · 2:50](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=170)
- "Pyloric stenosis is diagnosed on ultrasound when pyloric muscle is 3 millimeters thick and 14 millimeters long or greater" — Bhargava Muliudi (clinical) [Ep 2 · 2:55](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=175)
- "The classic electrolyte abnormality in pyloric stenosis is hypochloremic, hypokalemic, metabolic alkalosis" — Bhargava Muliudi (clinical) [Ep 2 · 3:19](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=199)
- "Prolonged gastric outlet obstruction leads to persistent vomiting and loss of hydrochloric acid, which leads to hypochloremia and loss of protons leading to metabolic alkalosis" — Bhargava Muliudi (clinical) [Ep 2 · 3:29](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=209)
- "The kidneys compensate for dehydration by increasing the activity of the sodium potassium pump to retain fluid, leading to urinary excretion of potassium to preserve sodium and water" — Bhargava Muliudi (clinical) [Ep 2 · 3:41](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=221)
- "In later stages of pyloric stenosis, excretion of protons leads to paradoxical aciduria, which further worsens metabolic alkalosis" — Bhargava Muliudi (clinical) [Ep 2 · 3:56](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=236)
- "In the US, pyloromyotomy is the standard of care for pyloric stenosis" — Bhargava Muliudi (guideline) [Ep 2 · 4:17](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=257)
- "In some countries, atropine is used as a non-surgical option for pyloric stenosis, with a success rate of about 60 to 90%" — Bhargava Muliudi (clinical) [Ep 2 · 4:22](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=262)
- "Cincinnati Children's follows a resuscitation protocol published by the Children's Mercy Group in Kansas City for pyloric stenosis" — Bhargava Muliudi (guideline) [Ep 2 · 4:41](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=281)
- "If chloride is less than 85, give 3 boluses separated by an hour and then recheck labs" — Bhargava Muliudi (guideline) [Ep 2 · 5:01](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=301)
- "If chloride is between 85 and 97, give two boluses" — Bhargava Muliudi (guideline) [Ep 2 · 5:10](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=310)
- "If chloride is greater than 97, give 1 bolus" — Bhargava Muliudi (guideline) [Ep 2 · 5:15](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=315)
- "If bicarbonate is greater than 40, give 3 boluses" — Bhargava Muliudi (guideline) [Ep 2 · 5:24](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=324)
- "If bicarbonate is greater than or equal to 33, give 2 boluses" — Bhargava Muliudi (guideline) [Ep 2 · 5:29](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=329)
- "Prior to going to the operating room, serum chloride must be corrected to greater than 100 and bicarbonate to less than 30" — Bhargava Muliudi (guideline) [Ep 2 · 5:48](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=348)
- "The proximal edge of the pylorus can be easily identified as the antrum transitions to a thick pylorus" — Bhargava Muliudi (clinical) [Ep 2 · 7:00](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=420)
- "The distal extent of the pyloromyotomy is generally to the crossing vein of Mayo or the white line, which marks the pyloroduodenal junction" — Bhargava Muliudi (clinical) [Ep 2 · 7:07](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=427)
- "After the pyloromyotomy is completed, the submucosa should bulge into the myotomy site" — Bhargava Muliudi (clinical) [Ep 2 · 8:18](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=498)
- "After adequate pyloromyotomy, each side of the pylorus should move independently" — Bhargava Muliudi (clinical) [Ep 2 · 8:25](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=505)
- "Complications from pyloromyotomy include incomplete myotomy, mucosal perforation, aspiration, wound infection, and incisional hernias" — Bhargava Muliudi (clinical) [Ep 2 · 8:42](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=522)
- "There is a slight increased risk of incomplete myotomy and perforation with a laparoscopic approach, but the overall low incidence of complications decreases the clinical significance of the differences between the two approaches" — Bhargava Muliudi (clinical) [Ep 2 · 8:52](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=532)
- "For mucosal perforation during pyloromyotomy, you can close the mucosa using a low profile needle and suture like Vicryl on a TF needle, or perform a full thickness repair and redo a myotomy about 180 degrees from the first one, usually on the posterior wall" — Bhargava Muliudi (clinical) [Ep 2 · 9:17](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=557)
- "Most infants can be fed immediately after pyloromyotomy" — Bhargava Muliudi (clinical) [Ep 2 · 10:05](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=605)
- "Evidence supports ad-lib feeds after pyloromyotomy; once the infant is alert and awake, these infants achieve full feeds sooner with no increase in readmission rates" — Bhargava Muliudi (clinical) [Ep 2 · 10:13](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=613)
- "Small episodes of emesis after pyloromyotomy are almost to be expected as the stomach recovers from days to weeks of progressive dilation" — Bhargava Muliudi (clinical) [Ep 2 · 10:32](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=632)
- "Odds of emesis is slightly higher in early and ad-lib feedings compared to gradual or delayed feedings, but the length of stay for ad-lib feedings is much shorter" — Bhargava Muliudi (clinical) [Ep 2 · 10:44](https://library.globalcastmd.com/watch/pyloric-stenosis-2532?t=644)
- "Pyloric stenosis incidence is approximately 4 to 5 in 1000 live births with heavy male preponderance." — Alex Bondoc (epidemiological) [Ep 3 · 3:05](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=185)
- "A 2017 Journal of Pediatric Surgery study of 584 patients found African American infants with pyloric stenosis presented with higher bicarbonate and lower chloride levels." — Em Gootee (host_summary) [Ep 3 · 3:24](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=204)
- "Uninsured families' babies had lower chloride and higher bicarbonate levels at presentation and longer times between diagnosis and OR." — Kim Pribbin (host_summary) [Ep 3 · 3:44](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=224)
- "A large-scale Denmark and Holland study found pyloric stenosis is 87% heritable." — Kim Pribbin (host_summary) [Ep 3 · 4:13](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=253)
- "Researchers have identified a molecular diagnostic marker and can trace specific genetic changes indicating risk for pyloric stenosis." — Em Gootee (host_summary) [Ep 3 · 4:25](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=265)
- "Ultrasound diagnostic criteria: muscle thickness greater than 4 millimeters and pyloric channel length greater than 15 millimeters suggest pyloric stenosis." — Kim Pribbin (host_summary) [Ep 3 · 6:23](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=383)
- "A 2008 and 2016 Journal of Pediatric Surgery study identified specific fluid resuscitation pathways that reduced blood draws and did not delay time to surgery." — Kim Pribbin (host_summary) [Ep 3 · 6:46](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=406)
- "Recommended fluid resuscitation: isotonic saline bolus followed by maintenance IV fluids (D5 half-normal saline with 20 mEq/L potassium chloride)." — Em Gootee (host_summary) [Ep 3 · 7:04](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=424)
- "Nasogastric decompression should be avoided to prevent exacerbation of metabolic alkalosis." — Kim Pribbin (host_summary) [Ep 3 · 7:18](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=438)
- "Atropine is traditional medical management but has fallen out of favor because pediatric anesthetists are skilled and there is low concordance between congenital anomalies creating high anesthetic risk." — Alex Bondoc (opinion) [Ep 3 · 7:34](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=454)
- "A 2023 Journal of Pediatric Surgery study suggests antibiotic prophylaxis may be unnecessary for pyloromyotomy and may carry unnecessary long-term side effects." — Em Gootee (host_summary) [Ep 3 · 8:12](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=492)
- "The first pyloromyotomy was performed the year before Ramstedt, who popularized it using a coffee spoon, intending pyloroplasty but performing only myotomy when the baby became unstable." — Alex Bondoc (clinical) [Ep 3 · 8:40](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=520)
- "Gastric suction in three positions (head down, right, left) while awake is performed before induction to prevent aspiration from the atonic stomach." — Alex Bondoc (clinical) [Ep 3 · 9:16](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=556)
- "For laparoscopic pyloromyotomy, 3-millimeter instruments are used through three incisions: umbilicus, right upper quadrant, and left upper quadrant." — Alex Bondoc (clinical) [Ep 3 · 10:12](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=612)
- "The 3-millimeter Maryland grasper when fully opened is 13 millimeters, so a 13mm myotomy on a 15-18mm channel will be incomplete." — Alex Bondoc (clinical) [Ep 3 · 10:57](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=657)
- "To assess myotomy completeness, both ends of separated muscle should move independently; resistance or connected movement indicates incomplete myotomy." — Kim Pribbin (host_summary) [Ep 3 · 11:49](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=709)
- "Air can be insufflated down a suction catheter to look for bubbles indicating mucosal perforation." — Alex Bondoc (clinical) [Ep 3 · 12:05](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=725)
- "Omentum is placed on top of the myotomy site." — Alex Bondoc (clinical) [Ep 3 · 12:20](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=740)
- "Open pyloromyotomy can be performed through a periumbilical incision with tunneling up to the right upper quadrant, taking advantage of babies' stretchable skin." — Alex Bondoc (clinical) [Ep 3 · 12:27](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=747)
- "Incisional hernias can occur because fascia is typically not closed on stab incisions in upper quadrants; omental hernias have been observed." — Alex Bondoc (clinical) [Ep 3 · 13:06](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=786)
- "Complication rates after pyloromyotomy are equivalent or better with open approach because laparoscopic pyloromyotomy is an experience and feel operation." — Alex Bondoc (opinion) [Ep 3 · 13:23](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=803)
- "Post-operative vomiting is very common and does not necessarily mean the operation did not work; the atonic stomach does not remodel immediately." — Alex Bondoc (clinical) [Ep 3 · 13:54](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=834)
- "Complete intolerance of feeds lasting into days post-operatively raises concern for incomplete myotomy." — Alex Bondoc (clinical) [Ep 3 · 14:13](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=853)
- "A flexible feeding protocol (reducing volume if baby vomits 6 times but continuing smaller feeds and increasing as tolerated) decreases length of hospital stay." — Em Gootee (host_summary) [Ep 3 · 14:30](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=870)
- "Studies on adults who had pyloromyotomy as children show they do not have major issues like nausea, vomiting, reflux, or other GI problems later in life, and long-term follow-up is usually not necessary." — Kim Pribbin (host_summary) [Ep 3 · 15:08](https://library.globalcastmd.com/watch/pyloric-stenosis-with-dr-alex-bondoc-8728?t=908)
- "In patients with spontaneous pneumomediastinum, esophagrams never showed any leak or injury in a 16-year retrospective review" — Todd Ponsky (host_summary) [Ep 1 · 4:36](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=276)
- "55% of spontaneous pneumomediastinum patients had CT scans and none showed positive findings" — Todd Ponsky (host_summary) [Ep 1 · 5:10](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=310)
- "In traumatic pneumomediastinum, esophagrams never showed findings in patients who looked clinically well" — Todd Ponsky (host_summary) [Ep 1 · 5:25](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=325)
- "Pneumomediastinum in trauma is not predictive of injury unless there is a wide mediastinum" (clinical) [Ep 1 · 6:41](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=401)
- "A high percentage of spontaneous pneumomediastinum patients had comorbidity of asthma" (epidemiological) [Ep 1 · 7:20](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=440)
- "For pyloric stenosis with chloride <85, give three 20 cc/kg normal saline boluses before rechecking labs" — Todd Ponsky (host_summary) [Ep 1 · 14:10](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=850)
- "For pyloric stenosis with chloride ≤97, give two 20 cc/kg normal saline boluses before rechecking labs" — Todd Ponsky (host_summary) [Ep 1 · 14:30](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=870)
- "For pyloric stenosis with chloride >97 but bicarbonate <33, give one 20 cc/kg normal saline bolus" — Todd Ponsky (host_summary) [Ep 1 · 14:45](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=885)
- "The pyloric stenosis resuscitation study used 20 cc/kg boluses of normal saline, not 10 cc/kg" — Todd Ponsky (host_summary) [Ep 1 · 16:40](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=1000)
- "Historical data about post-operative apnea in pyloric stenosis was based on anesthetics not used in 5 decades" (opinion) [Ep 1 · 16:58](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=1018)
- "Most esophageal atresia anastomotic leaks will resolve spontaneously with observation if the child is stable" — Steve (clinical) [Ep 1 · 17:52](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=1072)
- "Complete disruption of EA anastomosis within 2-3 days should be re-operated, unlike small leaks" — Steve (clinical) [Ep 1 · 19:05](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=1145)
- "Midwest Pediatric Surgery Consortium review of 400+ EA patients found trans-anastomotic tube associated with increased stricture and complication risk" — Dan (host_summary) [Ep 1 · 19:57](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=1197)
- "Great Ormond Street does not leave nasogastric tubes or chest tubes after EA repair and routinely feeds on day 2-3 without contrast study, with great results for 20 years" (host_summary) [Ep 1 · 21:54](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=1314)
- "In glycopyrrolate RCT for EA leaks, chest tube output was 124 mL in treatment group vs 370 mL in placebo group" — Todd Ponsky (host_summary) [Ep 1 · 23:50](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=1430)
- "Leak resolution in glycopyrrolate RCT was achieved in 76% of treatment group vs 29% of placebo group" — Todd Ponsky (host_summary) [Ep 1 · 24:10](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=1450)
- "Oral feeding after EA leak was achieved in 71% of glycopyrrolate group vs 14% of placebo group" — Todd Ponsky (host_summary) [Ep 1 · 24:25](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=1465)
- "The low closure rate in the glycopyrrolate study's control group (29%) may reflect short follow-up period rather than true failure to close" (opinion) [Ep 1 · 25:04](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=1504)
- "Neonatologists are concerned that glycopyrrolate may cause mucus plugs in EA patients" (clinical) [Ep 1 · 27:11](https://library.globalcastmd.com/watch/hot-new-topics-from-the-journal-of-pediatric-surgery-update-course-2017-404?t=1631)

## Changelog
- Sep 15: 3 items added automatically

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