Which physical finding is most commonly felt in pyloric stenosis?

• A. Olive-Sized Mass in Epigastrium
• B. Currant Jelly Stool
• C. Bilious Vomiting
• D. Bloody Stool

Answer: (A)

Hypertrophic pyloric stenosis classically presents with a palpable, firm, olive-sized mass in the epigastric region. This finding comes from thickening of the pyloric muscle and is the hallmark physical exam finding in affected infants, who typically have progressive nonbilious, projectile vomiting and may show visible gastric peristalsis after feeding. The mass is best felt when the stomach is distended, usually in a young infant around a few weeks old.

Currant jelly stool is characteristic of intussusception, not pyloric stenosis. Bilious vomiting suggests obstruction distal to the stomach and the bile duct, which is not typical for pyloric stenosis. Bloody stool also points away from pyloric stenosis and toward other GI issues.