What condition presents with an inability to tolerate feedings due to excessive vomiting in infants?

Pyloric stenosis is characterized by the narrowing of the pylorus, which is the opening from the stomach to the small intestine. This condition leads to impaired gastric emptying, resulting in excessive projectile vomiting, particularly occurring shortly after feedings. Infants with pyloric stenosis typically exhibit signs of hunger shortly after vomiting since they are unable to retain food in their stomachs.

The condition usually presents within the first few weeks of life and can lead to dehydration and electrolyte imbalances if not treated, which is why prompt recognition is critical in clinical practice. Parental report of frequent vomiting after feeding and the presence of a palpable "olive-like" mass in the abdomen may further support the diagnosis of pyloric stenosis.

Other conditions, like gastroesophageal reflux, may also cause vomiting but are generally associated with less severe feeding intolerance compared to pyloric stenosis. In contrast, herniation and celiac disease typically present with different symptoms such as abdominal pain, bloating, or malabsorption issues as the primary concerns rather than immediate vomiting due to feeding intolerance.