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Idiopathic Hypertrophie Pyloric Stenosis : Our Experience
B Puri1, D K Sreevastava2, A S Kalra3
1Senior Advisor (Surgery), Lucknow.
Insights
This study found that infants with hypertrophic pyloric stenosis (HPS) often differ from the typical profile. Our findings challenge traditional descriptions of HPS patient demographics and clinical presentation.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Idiopathic hypertrophic pyloric stenosis (IHPS) is typically described in male, first-born infants with a family history.
- This report presents a contrasting clinical experience with IHPS.
Purpose of the Study:
- To describe the clinical characteristics of infants with IHPS in our patient cohort.
- To compare these characteristics with established literature profiles.
Main Methods:
- Retrospective analysis of medical records for 8 infants diagnosed with IHPS.
- Surgical treatment (Ramstedt's pyloromyotomy) was performed after fluid and electrolyte correction.
Main Results:
- The cohort included 5 males and 3 females, with no family history and only one first-born infant.
- One infant was preterm, and one had a congenital anomaly (single kidney).
- Most infants presented with moderate dehydration and hypochloremic alkalosis; 75% were diagnosed on admission.
Conclusions:
- The clinical profile of IHPS in this series differs from the typical demographic and historical data.
- These findings suggest variability in IHPS presentation.
Background:
A typical infant with idiopathic hypertrophic pyloric stenosis is described as a male child, first in the order of birth with a positive family history. However our experience suggests otherwise which is presented in this report. Methods : A retrospective analysis of medical records of 8 infants, who were diagnosed to be suffering from idiopathic hypertrophic pyloric stenosis and subjected to surgical treatment, was undertaken.
Results:
There were 5 (62.5%) males and 3 (37.5%) females. There was no family history and only one child (12.5%) was first born in the order of birth. One infant was preterm and one case (12.5%) had associated congenital anomaly (single kidney). Definitive diagnosis was established in 6 (75%) babies at admission whereas, other 2 cases (25%) required further evaluation. All the infants were in a state of moderate dehydration and in a varying state of hypochloremic alkalosis. The pH and serum chloride levels ranged from 7.52 to 7.67 and 86-94 mmol/L respectively. All were subjected to traditional Ramstedt's pyloromyotomy after having undergone vigorous correction of fluids and electrolytes for 24-48 hours. Intraoperatively, there was one iatrogenic mucosal perforation, which was closed with an omental patch. Postoperative feeding was initiated 12 hrs after surgery in 6 (75%) babies.
Conclusion:
Our series suggests a clinical profile of hypertrophic pyloric stenosis in our subset of patients which is different from what is described in literature.
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