Presentation And Outcome Of Infantile Hypertrophic Pyloric Stenosis: A Five Year Retrospective Study In Chittagong Medical College (original) (raw)
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Infantile Hypertrophic Pyloric Stenosis: Presentation and Outcome in Khartoum Teaching Hospital
The Journal of medical research, 2014
Background/Aims : Infantile hypertrophic pyloric stenosis (IHPS) is a common cause of gastric outlet obstruction in infants, and presents as one of the most common surgical conditions of infancy. Although there were many published studies about IHPS worldwide; there was very few published study in our local literature. So we conduct this study to investigate IHPS in form of, presentation, management and overall outcome. Methodology : In this prospective cross - sectional, hospital based study; 42 patients with IHPS, were admitted in Khartoum Teaching hospital department of Pediatric Surgery in the period between Aug. 2011 and May. 2013. Patients were referred from all parts of Sudan. Study variables included were age, gender, and residence, presenting symptoms, clinical sign and postoperative outcomes. Data was collected using a structured, pretested questionnaire and analyzed using a computer program-Statistical Package for Social Sciences (SPSS) version 20. Results were presented ...
Infantile Hypertrophic Pyloric Stenosis Analysis of 84 Cases
TAJ: Journal of Teachers Association, 2009
This is a descriptive study carried out in the Department of Pediatric Surgery, Rajshahi Medical College Hospital and in the private clinics of Rajshahi, during the period of November 2000 to October 2004. Total 84 patients were treated by Ramstedt's pyloromyotomy after proper resuscitation. The male to female ratio was 5:1. Most of the patients presented to us within 40 days of age (90%). In 90% cases diagnosis were done on clinical basis. The diagnosis is confirmed by barium meal x-ray in 60 cases and sonogram in 71 cases. Serum electrolytes were estimated in all patients. There was metabolic derangement in more than 80% cases. There was no postoperative mortality. Oral feeding started after 6 hours postoperatively in 81 cases. Inadvertent mucosal perforation occurred in 3 cases and that was recognized and repaired successfully without any ill effect. Superficial wound infection encountered in 8.33% cases. doi: 10.3329/taj.v18i1.3297 TAJ 2005; 18(1): 14-16
BMC research notes, 2018
This study aimed to describe the clinical characteristics of patients with infantile hypertrophic stenosis, management and its outcome in two tertiary care centres in Cameroon. A total of 21 patients were included from the two centres. The mean age at presentation was 5.2 ± 1.2 weeks, predominantly male with a male-to-female ratio of 4.25:1. The triad of vomiting, visible peristalsis and palpable mass was present in only 7 (33.3%) of the participants. The diagnosis was confirmed with ultrasounds in all participants. Ramstedt pyloromyotomy was done in all participants and in 9.5% of the participants it was complicated by intra-operative duodenal perforation whereas in the postoperative period the most common complications were vomiting (6, 28.6%), sepsis (2, 9.5%), and paralytic ileus (2, 9.5%). The mortality rate from the series is 9.5%. According to univariate logistic regression: severe dehydration [OR = 5.41, 95% CI = (3.11-6.97), p = 0.002], hypokalaemia [OR = 2.63, 95% CI = (1....
Infantile hypertrophic pyloric stenosis: A clinical review from a general hospital
Journal of Paediatrics and Child Health, 1993
A review of 212 cases of infantile hypertrophic pyloric stenosis (IHPS) in a general hospital during an 8.5 year period documents clinical features and suggests refinement of treatment. Features such as sex, age at onset and presentation were similar to other studies. There was a preponderance of infants born in the summer. Premature infants represented 10% of the series, and the most premature (<33 weeks gestation) presented later after birth (40 vs25 days). Diagnosis was clinical in 65% of cases, but 4% presented before physical examination and diagnostic tests were positive. At the time of admission only 15% had significant abnormalities of serum electrolytes (chloride <85 mmol/L). The periumbilical incision resulted in a hidden scar. Duodenal perforation (3.3%) and wound dehiscence (1.4%) are related to technical factors and can be avoided. The timing of commencement of postoperative feeds did not influence the rate of vomiting. The average length of stay was 3.5 days. These results are discussed with suggestions about how to minimize diagnostic tests and length of hospital stay.
The Profile of Infantile Hypertrophic Pyloric Stenosis in a Tertiary Children's Hospital in Nepal
Journal of Nepal Paediatric Society
Introduction: Infantile Hypertrophic Pyloric Stenosis (IHPS) is the most common surgical cause of non-bilious vomiting in infancy and in the developed world. It is more common among male infants with a peak age at presentation of 4 weeks. This study aims to review the mean age at the time of diagnosis, serum electrolyte changes, ultrasonographic pyloric dimensions and surgical outcomes in IHPS at a tertiary children’s hospital in Nepal. Methods: A retrospective chart review of patients with IHPS who presented to Kanti Children’s Hospital between June 2016 and June 2020 was performed. Data on age, sex, laboratory and ultrasonographic dimensions, treatment and outcomes of treatment were collected and analysed. Results: The clinical record of 150 infants were retrieved and analysed who were diagnosed according to the clinical manifestations, laboratory and ultrasound examination from 2016 to 2020. The mean age at presentation was 46.57 ± 27.3 days with male preponderance of 84%. The pr...
Journal of Pediatric Surgery, 2003
Background: Ramstedt's pyloromyotomy has long been the standard operation for the treatment of infantile hypertrophic pyloric stenosis. Controversy exists over whether this procedure can be performed safely in the district general hospital setting or whether it should be restricted to specialist pediatric units only. Methods: Retrospective analysis was performed on the medical records of a series of 160 infants treated by Ramstedt's pyloromyotomy by 2 surgeons in a district general hospital over 16 years. Results: There was no perioperative mortality. Oral feeding was achieved by 24 hours in 76% of infants, and there was persistent vomiting in only 3.8%. Wound discharge was encountered in 4.4% and confirmed wound infection in 1.3%. Wound dehiscence occurred in 1.9% of infants. Inadvertent mucosal perforation occurred in 19% of cases, although all cases were recognized and repaired at once with no apparent ill effects. These results are comparable with those reported from specialist pediatric units and from pediatric surgeons working within general surgical units. Conclusions: Infantile hypertrophic pyloric stenosis can be treated safely in a district general hospital when care is provided by appropriately trained surgical, anesthetic, and pediatric staff.
Late onset Infantile Hypertrophic Pyloric Stenosis
Journal of Pediatric Surgery Case Reports, 2018
Infantile Hypertrophic Pyloric Stenosis (IHPS) is one of the most common surgical conditions of the newborn. It occurs at a rate of 1-4 per 1000 live births. Males are affected more often with a 4:1 male-to-female ratio. Risk factors for IHPS include family history, gender, younger maternal age, being a first-born infant, and maternal feeding patterns. The classic presentation of IHPS is nonbilious, projectile vomiting in a full-term neonate who is between 2 and 8 weeks old. Premature infants are diagnosed with IHPS later than term or post-term infants. The authors are reporting a case of IHPS in a 7 month old female baby weighing 3.8 kg presented with nonbilious vomiting, where history, examination and investigations support the diagnosis and Ramstedt's pyloromyotomy was performed. The case history is presented and discussed.
A Case Report on Pyloric Stenosis in Infants
Journal of Pharmaceutical Research International, 2021
Introduction: Pyloric stenosis also known as pylorostenosis or specifically as infantile hypertrophic pyloric stenosis (IHPS) is the tapering (stenosis) of the opening from the stomach to the first part of the small intestine (duodenum). The term “pylorus” indicates “gate”. The thickened pylorus is feels as an olive shaped abnormal mass in the upper right hypochondriac and epigastrium region of the infant’s abdomen. Clinical Findings: Frequent vomiting after feeding which is projectile,non-bilious, in nature. Continual hunger, dehydration, alterations in bowel movements, weight issues. Diagnostic Evaluation: History collection (family history), physical examination (olive shaped mass) at epigastrium, hematological test (CBC), biochemistry test (KFT) (electrolyte imbalance). Ultrasonography (USG) abdomen:- thickened pylorus (<3mm), narrowed pyloric lumen, gastric content can not pass to duodenum, superior mesenteric artery and superior mesenteric vein located without altered posit...
Pan African Medical Journal, 2016
A 24-day old female Nigerian neonate presented with protracted vomiting, fever and dehydration but without palpable abdominal tumour or visible gastric peristalsis. There was no derangement of serum electrolytes. The initial working diagnosis was Late-Onset Sepsis but abdominal ultrasonography showed features consistent with the diagnosis of IHPS. This case report highlights the atypical presentation of this surgical condition and the need to investigate cases of protracted vomiting in the newborn with at least, ultrasonography to minimize complications and reduce the risk of mortality in a resource-poor setting.
Journal of Paediatric Surgeons of Bangladesh, 2014
Background: Different treatment modalities and procedures have been tried for the management of infantile hypertrophic pyloric stenosis. But surgery remains the mainstay for management of IHPS. Ramstedts pyloromyotomy was described almost over a hundred years ago and to date remains the surgical technique of choice. An alternative and better technique is the double-Y pyloromyotomy, which offer better results for management of this common condition.Methods: A prospective comparative interventional study of 40 patients with IHPS was carried out over a period of 2 years from July 2008 to July 2010. The patients were divided into 2 equal groups of 20 patients in each. The study was designed that all patients selected for study were optimized preoperatively regarding to hydration, acid-base status and electrolytes imbalance. All surgeries were performed after obtaining informed consent. Standard preoperative preparation and postoperative feeding regimes were used. The patients were oper...