A nurse suspects a child has pyloric stenosis. Which finding is the most indicative of this condition?

Projectile vomiting is a hallmark sign of pyloric stenosis. This condition occurs when the pylorus, the opening between the stomach and the small intestine, becomes narrowed, obstructing food from entering the small intestine. As a result, when a child with pyloric stenosis feeds, the stomach fills but cannot adequately empty, leading to intense contractions and forceful expulsion of the stomach contents, which presents as projectile vomiting.

This symptom typically occurs shortly after feeding and is often described as being very forceful and sudden, distinguishing it from normal vomiting associated with other gastrointestinal conditions. The specific nature of the vomiting in pyloric stenosis, combined with the age of the child (usually presenting in infants around 3 to 12 weeks old), significantly adds to the suspicion of this condition.

Other findings, such as frequent constipation, gastric reflux, or excessive burping, do not provide the same direct connection to pyloric stenosis. While these symptoms can be present in various gastrointestinal issues, they are less specific and do not present with the same intensity or immediacy as projectile vomiting does in the context of pyloric stenosis. Thus, among the options provided, projectile vomiting is the most indicative symptom linked to this condition.