[Recurrent hypertrophic pyloric stenosis - diagnostics and treatment]

Hypertrophic pyloric stenosis (HPS) is the most common surgically treated disease causing vomiting in infancy, and pyloromyotomy presents around 30% of all operations in this period. Recurrence of the disease is the most serious complication in its treatment. For 16 years period (2000 - 2015) 154 children with HPS were operated n Pediatric Surgery, Plovdiv. Four of them (2.6%), two boys and two girls, were reoperated due to recurrent HPS. Three of the children were sent by other hospital, one of which having Pediatric Surgery, and the other two from regional hospitals. In one case the pyloromyotomy was performed by a general surgeon. The fourth child with recurrent HPS was operated in our clinic. Reoperations were performed between 3rd and 12th day after the first operation (mean 7.5 days). In one case a Heineke mikulicz pyloroplasty was the procedure of choice, and in the other three cases a new pyloromyotomy was made in a different place. Pyloromyotomy for HPS is a routine procedure in pediatric surgery, which has its typical complications and one such is the recurrent HPS. Insufficiently performed pyloromyotomy is among the leading causes for recurrent HPS, therefore, a high level of competence in every surgeon performing it is crucial.