Lethargy in Pediatrics — Case | General Pediatrics | SMLE Q#17096
SMLE Question #17096
Pediatrics
General Pediatrics
Objective: OBJ-377
Last updated: February 2026
A 3-week-old first-born boy has 5 days of forceful, non-bilious vomiting after feeds with lethargy and fewer wet diapers. He appears mildly dehydrated. Abdominal examination shows visible peristaltic waves and a small, firm, mobile right upper quadrant mass. Serum studies are consistent with hypochloremic, hypokalemic metabolic alkalosis. Abdominal ultrasound shows a thickened pylorus. What is the most appropriate initial management step?
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