Snapshot An anxious young married couple presents to the ED with their 3-week-old firstborn. They report that the child was feeding well for the first two weeks after delivery but over the past few days he has taken less breast milk. Two days ago he experienced projectile vomiting after every meal. The mom and dad are concerned that he might have the stomach flu. Overview Introduction A congenital stenosis of the pyloric sphincter login to view 2 more bullets May be aquired in adult cases with stricture following chronic ulcer disease Associated with the use of macrolides in newborns Presentation Symptoms login to view 2 more bullets Physical exam login to view 2 more bullets Evaluation Ultrasound is diagnostic Treatment Medical management login to view 2 more bullets Surgical login to view 1 more bullet