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Infantile hypertrophic pyloric stenosis and hydronephrosis: is there an association?
M Bidair1, S J Kalota, G W Kaplan
1Division of Urology, Children's Hospital, San Diego, California.
Insights
Infantile hypertrophic pyloric stenosis (IHPS) is common in newborns. A study found a higher incidence of urinary tract anomalies in IHPS patients, suggesting a link that warrants further investigation.
Area of Science:
- Pediatric Surgery
- Urology
- Medical Genetics
Background:
- Infantile hypertrophic pyloric stenosis (IHPS) is a frequent neonatal surgical condition.
- Associated anomalies in IHPS patients typically involve the central nervous system, gastrointestinal tract, and heart.
Observation:
- A review of 422 IHPS patients identified urinary tract anomalies in 6 cases (1.4%).
- These anomalies included vesicoureteral reflux and hydronephrosis, occurring at a higher rate than in the general population.
Findings:
- The incidence of urinary tract anomalies in IHPS patients was significantly higher (1.4%) compared to the general population (0.2%).
- This represents a 7-fold increase, suggesting a potential association between IHPS and urinary tract anomalies.
Implications:
- The findings suggest a possible link between infantile hypertrophic pyloric stenosis and urinary tract anomalies.
- Routine renal ultrasound screening for IHPS patients is recommended to detect associated urinary tract abnormalities.
Abstract:
Infantile hypertrophic pyloric stenosis is a common condition requiring surgical intervention during the first few weeks of life. The incidence of infantile hypertrophic pyloric stenosis ranges from 0.13 to 0.4% of live births in the United States, Britain and Scandinavia. Associated anomalies have been described in 6 to 33% of the cases in the central nervous system, gastrointestinal tract and heart. An association of infantile hypertrophic pyloric stenosis with urinary tract anomalies has not been previously documented. A review of 422 patients with infantile hypertrophic pyloric stenosis revealed urinary tract anomalies in 6 (10 renal units), including 4 renal units with vesicoureteral reflux and 9 with hydronephrosis. This incidence of 1.4% is greater than the 0.2% incidence expected in the general population. This 7-fold increase in urinary tract anomalies in patients with infantile hypertrophic pyloric stenosis suggests an association between the two and warrants further investigation. Serious consideration should be given to obtaining renal ultrasound examinations in patients with infantile hypertrophic pyloric stenosis.