Clinical Analysis of Infantile Hypertrophic Pyloric Stenosis.
- Author:
Young Soo HUH
1
;
Myeung Kook LIM
;
Kyu Rak KIM
Author Information
1. Department of Pediatric Surgery, College of Medicine, Yeungnam University, Taegu, Korea.
- Publication Type:Original Article
- Keywords:
Hypertrophic pylorc stenosis;
Infantile
- MeSH:
Body Weight;
Electrolytes;
Female;
Humans;
Hypokalemia;
Infant;
Live Birth;
Male;
Postoperative Complications;
Pyloric Stenosis, Hypertrophic*;
Pylorus;
Standard of Care;
Ultrasonography;
Vomiting;
Wound Infection
- From:Journal of the Korean Association of Pediatric Surgeons
1998;4(1):39-47
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Infantile hypertrophic pyloric stensosis (IHPS), which occurs three of 1,000 live births, is a major cause of nonbilious vomiting of early infancy, but its etiology and pathogenesis are still obscure. The operation of pyloromyotomy as described by Ramstedt in 1912 remains the standard of care for the treatment of IHPS. From January 1990 to July 1997, 64 infants with IHPS were reviewed at department of Pediatric Sursery, Yeungnam University Hospital. The ratio of male to female was 7:1, and the most prevalent age group was between 2 weeks and 8 weeks (81.2%). There were 37 (57.8%) first born babies among total 64 infants. The body weight percentile at admission was lower than 50 percentile in all 64 cases. Onset of symptoms was predominantly between 2week and 4weeks in 23 cases (35.9%). All had a history of nonbilious vomting, generally projectile in nature. In the measured serum electrolytes, hypokalemia was noted in 14 cases (21.9%), hypochloremia was observed in 26 cases (40.6%). In the preoperative ultrasonography, the average muscle thickness, diameter, and length of the pylorus were 6.3mm, 12.3mm, and 17.8mm, respectively. A total of thirteen associated anomalies were noted in twelve patients. All 64 cases were treated with Fredet-Ramstedt pyloromyotomy. There were postoperative complications of wound infection in 3 cases. Intermittent nonprojectile vomiting was presented in 13 cases (20.3%) after operation, but one of them was relieved in 13 days and the rest were relieved within one week by adjustment of oral intake.