Excessive vomiting with gastric outlet obstruction secondary to pyloric stenosis leads to -
Hypokalemic hypochloremic metabolic alkalosis
Hypokalemic hyperchloremic metabolic acidosis
Hyperkalemic hyperchloremic metabolic alkalosis
Hyperkalemic hypochloremic metabolic acidosis
Ans. is 'a' i.e., Hypokalemic hypochloremic metabolic alkalosis Metabolic consequences of persistent vomiting in case of pyloric stenosis:* The metabolic consequences of benign pyloric stenosis are unique.* The vomiting of hydrochloric acid results in hypochloraemic alkalosis.* Initially, the sodium and potassium may be relatively normal. However, as dehydration progresses, more profound metabolic abnormalities arise, partly related to renal dysfunction.* Initially, the urine has a low chloride and high bicarbonate content, reflecting the primary metabolic abnormality. This bicarbonate is excreted along with sodium, and so with time the patient becomes progressively* Hyponatraemic and more profoundly dehydrated.* Because of the dehydration, a phase of sodium retention follows and potassium and hydrogen are excreted in preference.* This results in the urine becoming paradoxically acidic and hypokalaemia ensues. This finally culminates into hypokalemic hypochloremic metabolic alkalosis.* Alkalosis leads to a lowering in the circulating ionised calcium, and tetany can occur.
Stomach & Duodenum