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K31.1 – Adult Hypertrophic Pyloric Stenosis

K31.1 is an ICD-10 diagnosis code for adult hypertrophic pyloric stenosis, a narrowing of the gastric outlet that obstructs the passage of food into the small intestine.

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Things worth knowing about "K31.1"

K31.1 is an ICD-10 diagnosis code for adult hypertrophic pyloric stenosis, a narrowing of the gastric outlet that obstructs the passage of food into the small intestine.

What does the ICD-10 Code K31.1 mean?

The ICD-10 code K31.1 refers to adult hypertrophic pyloric stenosis. This is a narrowing (stenosis) of the pylorus – the junction between the stomach and the duodenum (small intestine) – caused by a thickening (hypertrophy) of the muscular layer. This condition impairs or prevents the emptying of stomach contents into the intestine.

Causes

Hypertrophic pyloric stenosis in adults is considerably rarer than in infants. Possible causes include:

Primary (idiopathic) form: Thickening of the pyloric muscle without an identifiable underlying disease, possibly as a late manifestation of infantile pyloric stenosis
Secondary form: Develops as a consequence of other conditions such as chronic peptic ulcers, gastric cancer, Crohn's disease, or chronic gastritis in the pyloric region
Scar-related strictures: Resulting from repeated inflammation or extension of ulcers to the pylorus

Symptoms

The symptoms associated with K31.1 often develop gradually. Typical symptoms include:

Postprandial vomiting: Projectile vomiting of undigested food shortly after eating
Epigastric pain: Pressure sensation or pain in the upper abdomen
Early satiety and bloating
Weight loss due to impaired food intake
Electrolyte disturbances (e.g., hypochloremic alkalosis) in chronic cases
Visible gastric peristalsis in the upper abdomen (in lean patients)

Diagnosis

Several diagnostic methods are available to confirm this diagnosis:

Esophagogastroduodenoscopy (gastroscopy): Gold standard for direct assessment of the pylorus, exclusion of malignancy, and biopsy
Abdominal ultrasound: Can detect thickening of the pyloric musculature
Barium meal X-ray (upper GI series): Demonstrates delayed gastric emptying and pyloric narrowing
CT abdomen: Used to rule out tumors or other organic causes
Laboratory tests: Detection of electrolyte disturbances (hyponatremia, hypokalemia, metabolic alkalosis)

Treatment

Conservative Management

In mild cases or when a secondary cause can be addressed:

Treatment of the underlying condition (e.g., acid suppression therapy with proton pump inhibitors for peptic ulcer)
Dietary adjustments (small, frequent meals, liquid diet)
Correction of electrolyte imbalances via intravenous infusion

Endoscopic Treatment

Pneumatic balloon dilation: Widening of the pylorus using a balloon via endoscope – the preferred minimally invasive approach
Endoscopic incision: Cutting the pyloric muscle in refractory cases

Surgical Treatment

Pyloromyotomy (Ramstedt procedure): Longitudinal splitting of the thickened pyloric muscle without opening the mucosa
Pyloroplasty or gastric resection: Indicated for secondary causes (e.g., tumor) or complicated cases

References

World Health Organization (WHO) – ICD-10 Version 2019: K31.1 Adult hypertrophic pyloric stenosis. https://icd.who.int/browse10/
Iqbal, C. W. et al. – Adult hypertrophic pyloric stenosis. Journal of Gastrointestinal Surgery, 2006. https://pubmed.ncbi.nlm.nih.gov/
Feldman, M., Friedman, L. S., Brandt, L. J. – Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 11th edition, Elsevier, 2021.

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