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Published on: July 8, 2025
INFANTILE HYPERTROPHIC PYLORIC STENOSIS IN NIGERIA: A MULTICENTER RETROSPECTIVE STUDY
D Olulana1, F Kumolalo1,2, A Ajao1,3
1Department of Surgery, University College Hospital, Ibadan, Nigeria.
Insights
Infantile hypertrophic pyloric stenosis (IHPS) affects infants worldwide. This Nigerian study found similar IHPS epidemiology and good outcomes compared to global data, with longer symptom duration linked to mortality.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Epidemiology
Background:
- Infantile hypertrophic pyloric stenosis (IHPS) exhibits variable incidence globally.
- This study focuses on IHPS epidemiology, clinical presentation, and management in Nigeria.
Purpose of the Study:
- To analyze the epidemiology of IHPS in Nigeria.
- To describe the clinical presentation and management of IHPS.
- To assess outcomes and identify factors influencing complications and mortality.
Main Methods:
- Retrospective analysis of 131 IHPS cases across six Nigerian pediatric surgical centers.
- Data collected and analyzed using descriptive statistics and Spearman's correlation (p < 0.05).
Main Results:
- IHPS predominantly affected male infants (M:F ratio 5:1), with a median age of 6 weeks.
- Electrolyte disturbances were common (48.1%), including hyponatremia and hypokalemia.
- Peri-operative mortality was 5.3%; longer symptom duration, jaundice, and elevated creatinine correlated with complications and mortality.
Conclusions:
- Nigerian IHPS epidemiology and clinical presentation align with international findings.
- Outcomes are comparable to other Low Middle Income Countries, demonstrating good post-operative results.
- Early presentation is crucial to minimize complications and mortality in IHPS patients.
Background:
Infantile hypertrophic pyloric stenosis (IHPS) is a disease whose incidence varies across the different races worldwide. This study examined the epidemiology, clinical presentation and management of IHPS in Nigeria.
Patients And Methods:
A retrospective study of cases of IHPS was conducted across six paediatric surgical centres in Nigeria with complements of at least two paediatric surgeons and high patient turn overs. Data collected were analyzed, the results obtained were expressed in simple percentages, mean ± standard deviation while linear relationships were obtained using Spearman's correlation and the level of significance set at p < 0.05.
Results:
One hundred and thirty-one patients were managed across the six centres in Nigeria, their ages ranged from 5 days - 44 weeks with a median of 6 weeks. There were 109 (83.2%) boys and 22 (16.8%) girls (M: F = 5:1). Electrolyte derangement was observed in 63(48.1%) patients (hyponatraemia - 42.0%, hypokalaemia - 35.9%, hypochloraemia - 32.1% and metabolic acidosis - 39.7%). The peri-operative mortality rate in this review was 5.3%. Post-operative complications had statistically significant association with longer duration of symptoms before presentation (p = 0.037), presence of jaundice (p = 0.024) and raised levels of creatinine at presentation (p = 0.002). Longer duration of symptoms before presentation (p = 0.037) were significantly associated with mortality.
Conclusion:
The epidemiology and clinical presentations are still similar to findings from outside Nigeria but comparable to other Low Middle Income Countries and post-operative outcome is also comparably good.
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