Biochemical disturbances
Biochemical disturbances in adult pyloric stenosis may be summarised as follows:
- the patient is dehydrated and the haematocrit level is raised
- the urine is scanty, concentrated, initially alkaline, but later acid; its chloride content is reduced or absent
- serum chloride is lowered because of the vomitus losses
- serum sodium and potassium are lowered as a result of the kidney exchanging sodium ions and some potassium ions for hydrogen ions lost in the vomitus
- the plasma bicarbonate is raised
- the urea level is raised because of dehydration
- the result of all these changes is the development of a hypochloraemic alkalosis
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