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Presentation and outcomes in hypertrophic pyloric stenosis: An 11-year review

Toby I Vinycomb1, Kirby Laslett2, Stella M Gwini3

  • 1Department of Paediatric Surgery, Royal Children's Hospital, Melbourne, Victoria, Australia.

Journal of Paediatrics and Child Health
|January 25, 2019
PubMed

Insights

Infants with hypertrophic pyloric stenosis (HPS) are not diagnosed earlier, despite perceptions. Biochemical derangements remain crucial for HPS diagnosis, emphasizing fluid and electrolyte management.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology

Background:

  • Hypertrophic pyloric stenosis (HPS) is a common surgical condition in infants.
  • Clinical presentation and diagnostic approaches for HPS have evolved over time.

Purpose of the Study:

  • To evaluate trends in the presentation and postoperative outcomes of infants with HPS over a decade.
  • To assess changes in diagnostic features and their impact on surgical outcomes.

Main Methods:

  • A multicentre retrospective study involving 626 infants who underwent pyloromyotomy for HPS between 2005 and 2015.
  • Data collected included presentation features (age, weight, clinical signs, blood gas results, ultrasound) and postoperative outcomes (length of stay, complications, time to first feed).

Main Results:

  • No significant trends were observed in infant age, weight, or biochemical findings at presentation.
  • A downtrend in palpable tumors was noted, with 36% palpated on average.
  • Pyloric wall thickness showed a moderate association with longer hospital stays.
  • Median time to first postoperative feed improved annually.

Conclusions:

  • Contrary to assumptions, infants with HPS are not being identified at an earlier age or with fewer biochemical derangements.
  • Biochemical derangements remain important in HPS diagnosis, necessitating careful fluid and electrolyte management.
Abstract

Keywords:
paediatric surgerypyloric stenosispyloromyotomy

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