Study of clinical, biochemical evaluation and outcome in hypertrophic pyloric stenosis
DOI:
https://doi.org/10.18203/2349-3291.ijcp20160698Keywords:
Infantile hypertrophic pyloric stenosis, Non bilious vomiting, DyselectronemiaAbstract
Background: Gastric outlet obstruction (GOO) in infancy and childhood may result from congenital causes, antral diaphragm, pyloric atresia, heterotrophic pancreas, and infantile hypertrophic pyloric stenosis (IHPS), or acquired causes (peptic ulcer, caustic ingestion, tumour, chronic granulomatous disease and Eosinophilic gastroenteritis). Infantile hypertrophic pyloric stenosis (IHPS) is among the most common surgical disorders in infancy and presents in approximately 3:1000 live births in the United States. In India it is estimated to be 1 in 3,500 live births. The objective of the study was to analyse the age and sex of presentation, try to compare preoperative and postoperative biochemical alteration and find out how to reduce the incidence of complications of infantile hypertrophic pyloric stenosis (IHPS).
Methods: Children attending at surgery OPD or emergency UP RIMS & R for no bilious vomiting during 15 March 2015 to 15 February 2016 less than 1 Year of age of both sex.
Results: We found that IHPS was more common among first born male child in more commonly in Hindus and most common time of presentation is first 8 weeks dyselectronemia was a common feature.
Conclusions: Infantile hypertrophic pyloric stenosis (IHPS) which is caused by thickened antropyloric muscle is a disease which causes gastric outlet obstruction. It is the most common surgical condition in infants within two month of postnatal life. This disease is presented with projectile non-bilious vomiting which may be blood tinged if it is prolonged without correction may cause hypochloremic hypokalemic alkalosis and death in more than 50% of the affected patients.
Metrics
References
Sharma KK, Agrawal P, Toshiniwal H. Acquired gastric outlet obstruction during infancy and childhood: a report of five unusual cases. J Pediatric Surg. 1997;32:928-30.
Ormarsson OT, Haugen SE, Juul I. Gastric outlet obstruction caused by heterotopic pancreas. Eur J Peditr Surg. 2003;13:410-3.
Ciftci AO, Tanyel FC, Kotiloglu E. Gastric lymphoma causing gastric outlet obstruction. J. Ped. Surg. 1996;31:1424-6.
Granot E, Matoth I, Korman SH. Functional gastrointestinal obstruction in a child with chronic granulomatous disease. J Pediatr Gastroenterol Nutr. 1986;5:321-3.
Eckert JW, Abramson SL, Starke J. The surgical Implications of chronic granulomatous disease. Am J Surg. 1994;169:320-3.
Cremin BJ. Neonatal pre-pyloric membrane. S Afr Med J. 1967;41:1076-9.
Joseph TP, Nair RR. Congenital hypertrophic pyloric stenosis. Indian J Surg. 1974;36:221.
Dye TE, Vidals VG, Lockhart CE, Snider WR: Adult hypertrophic pyloric stenosis. Am Surg. 1979;45(7):478-84.
MacDonald JA. Adult hypertrophic pyloric stenosis. Br J Surg. 1973;60(1):73-5.
Thielemann H, Anders S, Naveke R, Diermann J. Primary hypertrophic pyloric stenosis: a rare form and stomach outlet stenosis in the adult. Zentralbl. Chir. 1999;124(10):947-9.
Wajja TA, Wales PW. Population demographic indicators associated with incidence of pyloric stenosis. Arch Pediatr Adolesc Med. 2005;159:520-5.
Rice HE, Caty MG, Glick PL. Fluid therapy for the pediatric surgical patient. Ped Clin North Am. 1998;45:719-27.
Howe CT, Lequesne LP. Pyloric stenosis: the metabolic effects. Br J Surg. 1964;51:923-32.
Allan C. Determinants of good outcome in pyloric stenosis. J Paed Child Health. 2006;42(3):86-8.
Sharma KK, Agrawal P, Toshiniwal H. Acquired gastric outlet obstruction during infancy and childhood: A report of five unusual cases. J Pediatr Surg. 1997;32:928-30.
Ciftci AO, Tanyel FC, Kotiloglu E. Gastric lymphoma causing gastric outlet obstruction. J Pediatr Surg. 1996;31:1424-6.
Granot E, Matoth I, Korman SH. Functional gastrointestinal obstruction in a child with chronic granulomatous disease. J Pediatr Gastroenterol Nutr. 1986;5:321-3.
Eckert JW, Abramson SL, Starke J. The surgical implications of chronic granulomatous disease. Am J Surg. 1994;169:320-3.
Cremin BJ. Neonatal pre-pyloric membrane. S Afr Med J. 1967;41:1076-9.
Rollins MD, Shields MD, Quinn RJM. Pyloric stenosis: congenital or acquired? Arch Dis Child. 1989;64:138-47.
Puri P, Lakschmanadass G. Hypertrophic pyloric stenosis. In: Puri P (ed) Newborn surgery. Butterworth-Heinemann, Oxford. 1996:266-271.
Liao Z, Li Z, Zhang W. Education and imaging. Gastro- intestinal: infantile hypertrophic pyloric stenosis. J Gastro-enterol Hepatol. 2007;22(10):1692.
Mitchell LE, Risch N. The genetics of infantile hypertrophic pyloric stenosis. Am J Dis Child. 1993;147:1203.
Mac Mahon B. The continuing enigma of pyloric stenosis of infancy: a review. Epidemiol. 2006;17(2):195-201.
Taylor ND, Cass DT, Holland AJ. Infantile hypertrophic pyloric stenosis: has anything changed. J Paediatr Child Health. 2013;49(1):33-7.
Wilkinson DJ, Chapman RA, Owen A. Hypertrophic pyloric stenosis: predicting the resolution of biochemical abnormalities Pediatr Surg Int. 2011;27:695-98.
Iqbal CW, Rivard DC. Evaluation of ultrasonographic parameters in the diagnosis of pyloric stenosis relative to patient age and size. J Pediatr Surg. 2012;1542-7.
Banieghbal B. Rapid correction of metabolic alkalosis in hypertrophic pyloric stenosis with intravenous cimetidine: preliminary results. Pediatr Surg Int. 2009;25(3):269-71.