scholarly journals Pyloric stenosis at a tertiary hospital in Uganda

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Innocent Okello ◽  
Rovine Naluyimbazi ◽  
Alicia Massenga ◽  
Sarah Ullrich ◽  
Nasser Kakembo ◽  
...  
Keyword(s):  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Surgical Care ◽  
Tertiary Hospital ◽  
Electrolyte Imbalance ◽  
Unknown Etiology ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Patient Records ◽  
Improved Outcomes ◽  
Late Referral

Abstract Background Worldwide, infantile hypertrophic pyloric stenosis has an incidence of 3 in 1000 livebirths, with an unknown etiology. Even when babies present with characteristic symptoms, it is often misdiagnosed leading to late referral for appropriate surgical care. The purpose of this study was to document our experience in management of pyloric stenosis within our setting. Results A total of 33 patient records were reviewed. All the patients presented with non-bilious vomiting. The ratio of males to females was 4.5:1. Of these patients, 76% had electrolyte imbalance with low chloride count in the majority of patients. All the patients underwent an open Ramstedt pyloromyotomy, and 91% had a good outcome. Conclusion Management of IHPS has very good outcomes in our setting. Earlier referral of patients leads to improved outcomes.

ORAL MICROVASCULAR NETWORK GEOMETRY ABNORMALITIES IN INFANTILE HYPERTROPHIC PYLORIC STENOSIS

Fractals ◽  
2004 ◽  
Vol 12 (03) ◽  
pp. 311-318 ◽  
Author(s):  
STEFANO PARRINI ◽  
GIORGIO BIANCIARDI ◽  
GIUSEPPE LATINI ◽  
GIOVANNI DI MAGGIO ◽  
CLAUDIO DE FELICE
Keyword(s):  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Unknown Etiology ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Vascular Networks ◽  
Box Counting ◽  
Gender And Age ◽  
Lower Blood ◽  
Surgical Condition ◽  
Size Scales

Infantile hypertrophic pyloric stenosis (IHPS) is a common surgical condition of unknown etiology. The oral mucosal vascular networks of IHPS patients (n=25) and their unaffected parents showed lower blood vessel-free areas, as well as higher box-counting dimensions at two box size scales [D(1–46), D(1–15)], and relative Lempel-Ziv values (P<0.000001), as compared to those of gender- and age-matched controls. These findings may provide a useful phenotypical marker for identifying couples potentially at risk for the birth of an affected infant, while supporting the importance of a genetic component in this condition.

scholarly journals Infantile Hypertrophic Pyloric Stenosis - Experiences of 77 Cases

1970 ◽  
Vol 6 (1) ◽  
pp. 2-4
Author(s):  
AC Paul ◽  
MJ Alam ◽  
MK Hassan ◽  
MA Hannan ◽  
NK Das ◽  
...  
Keyword(s):  
Local Anesthesia ◽  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Barium Meal ◽  
Outlet Obstruction ◽  
Oral Feeding ◽  
Electrolyte Imbalance ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Female Ratio ◽  
Mucosal Perforation

Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of gastric outlet obstruction in infants which needs surgical treatment. The aim of this study was to review the management of IHPS in our hospital to compare with other developed centers. This is a prospective analytical study carried out in the Department of Pediatric Surgery, Faridpur Medical College Hospital and Dr. Zahed Children Hospital at Faridpur, during the period of May 2002 to October 2010. Total 77 patients were treated by Ramstedt's pyloromyotomy after proper diagnosis and resuscitation. The male to female ratio was 10:1. Most of the patients presented to us within 40 days of age (90%).Younger one was 15 days and elder one was 69 days. In all cases diagnosis were done on clinical basis. The diagnosis is confirmed by barium meal x-ray in 71 cases and sonogram in 15 cases. Serum electrolytes were not estimated in all patients. There was moderate to severe dehydration in more than 60% cases. 71 cases were operated under general anesthesia and 06 cases were operated with local anesthesia. There was one postoperative death on 4th post-operative day. Oral feeding started after 8 to 10 hours postoperatively in all cases. Mucosal perforation occurred in 1 case and that was recognized and treated conservatively without any ill effect. Superficial wound infection encountered in 3 cases. Early diagnosis, preoperative correction of dehydration and electrolyte imbalance and experiences of surgeons play important role for management of IHPS. Key words: IHPS; Pyloromyotomy; Dehydration; Local anesthesia; Mucosal perforation. DOI: 10.3329/fmcj.v6i1.7401 Faridpur Med. Coll. J. 2011;6(1): 02-04

scholarly journals Ultrasonographic Evaluation in Early Diagnosis of Infantile Hypertrophic Pyloric Stenosis

2021 ◽  
Vol 28 (2) ◽  
pp. 208-211
Author(s):  
Gopal Chandra Saha ◽  
Prodip Kumar Biswas ◽  
Md Nasir Uddin ◽  
Sahadat Hossain ◽  
Nur Wa Bushra Jahan ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Outlet Obstruction ◽  
Muscle Thickness ◽  
Electrolyte Imbalance ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Female Ratio ◽  
Pyloric Muscle ◽  
Pyloric Canal

Background: Infantile hypertrophic pyloric stenosis (IHPS) is a common cause of gastric outlet obstruction in infants. This study was conducted to identify the accuracy of ultrasonography in the diagnosis of infantile Hypertrophic pyloric Stenosis. Methods: This cross-sectional descriptive. Study was conducted in Department of radiology and imaging, institute of child and mother health during two year period from 16th September 2016 to 16th September 2018. Fifty patients <8 weeks of age who presented with complaints of non-bilious vomiting were included in the study. Abdominal ultrasound was performed in all the cases. On ultrasonography pyloric canal length, diameter and pyloric muscle wall thickness was measured. Open surgery was performed as per indications and after informed consent. The pre-operative findings were compared with ultrasongraphic findings. Study variable were male to female ratio, percentage of cases in which pyloric mass was palpable. We also compare the duration of onset of symptoms with pyloric canal length, diameter and muscle thickness. Results: In this study, out of 50 patients, 46 (92%) were male and 4 (8%) were females. Gastric peristalsis was visible in 100% patients and mass was palpable in 14 (28%) patients. Pyloric canal length was more than standard in 98% cases; canal diameter was more than the standard in 87% cases and pyloric muscle thickness in 60% of cases. Ultrasonographic findings remained 98% accurate in this study. Conclusion: Ultrasonography is an investigation of choice for early diagnosis of IHPS before significant fluid and electrolyte imbalance occur. It is cost effective, harmless, freely available and easier to perform. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 208-211

To Manage Infantile Hypertrophic Pyloric Stenosis by "Double-Y Pyloromyotomy" is a better Surgical Approach

2014 ◽  
Vol 1 (2) ◽  
pp. 143-147
Author(s):  
Md. Ansar Ali ◽  
Kaniz Hasina ◽  
Shahnoor Islam ◽  
Md. Ashraf Ul Huq ◽  
Md. Mahbub-Ul Alam ◽  
...  
Keyword(s):  
Weight Gain ◽  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Treatment Modalities ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Postoperative Vomiting ◽  
Acid Base ◽  
Feeding Regimes ◽  
Acid Base Status ◽  
Postoperative Feeding

Background: Different treatment modalities and procedures have been tried for the management of infantile hypertrophic pyloric stenosis. But surgery remains the mainstay for management of IHPS. Ramstedt’s pyloromyotomy was described almost over a hundred years ago and to date remains the surgical technique of choice. An alternative and better technique is the double-Y pyloromyotomy, which offer better results for management of this common condition.Methods: A prospective comparative interventional study of 40 patients with IHPS was carried out over a period of 2 years from July 2008 to July 2010. The patients were divided into 2 equal groups of 20 patients in each. The study was designed that all patients selected for study were optimized preoperatively regarding to hydration, acid-base status and electrolytes imbalance. All surgeries were performed after obtaining informed consent. Standard preoperative preparation and postoperative feeding regimes were used. The patients were operated on an alternate basis, i.e., one patient by Double-Y Pyloromyotomy(DY) and the next by aRamstedt’s Pyloromyotomy (RP). Data on patient demographics, operative time, anesthesia complications, postoperative complications including vomiting and weight gain were collected. Patients were followed up for a period of 3 months postoperatively. Statistical assessments were done by using t test.Results: From July 2008 through July 2010, fourty patients were finally analyzed for this study. Any statistical differences were observed in patient population regarding age, sex, weight at presentation, symptoms and clinical condition including electrolytes imbalance and acid-base status were recorded. Significant differences were found in postoperative vomiting and weight gain. Data of post operative vomiting and weight gain in both groups were collected. Vomiting in double-Y(DY) pyloromyotomy group (1.21 ± 0.45days) vs Ramstedt’s pyloromyotomy (RP) group(3.03 ± 0.37days) p= 0.0001.Weight gain after 1st 10 days DY vs RP is ( 298 ± 57.94 gm vs193±19.8 gm p=0.0014), after 1 month (676.67±149.84 gm vs 466.67 ± 127.71 gm, p=0.0001), after 2months (741.33± 278.74 gm vs 490±80.62 gm, p=0.002) and after 3 months (582±36.01gm vs 453.33±51.64 gm, p=0.0001).No long-term complications were reported and no re-do yloromyotomy was needed.Conclusion: The double-Y pyloromyotomy seems to be a better technique for the surgical management of IHPS. It may offer a better functional outcome in term of postoperative vomiting and weight gain.DOI: http://dx.doi.org/10.3329/jpsb.v1i2.19532

scholarly journals Integrating genetics with newborn metabolomics in infantile hypertrophic pyloric stenosis

Metabolomics ◽  
2021 ◽  
Vol 17 (1) ◽  
Author(s):  
João Fadista ◽  
Line Skotte ◽  
Julie Courraud ◽  
Frank Geller ◽  
Sanne Gørtz ◽  
...  
Keyword(s):  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Dried Blood Spots ◽  
Population Based ◽  
Case Control ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Sphincter Muscle ◽  
Feeding Patterns ◽  
Matched Case ◽  
Selection Of

Abstract Introduction Infantile hypertrophic pyloric stenosis (IHPS) is caused by hypertrophy of the pyloric sphincter muscle. Objectives Since previous reports have implicated lipid metabolism, we aimed to (1) investigate associations between IHPS and a wide array of lipid-related metabolites in newborns, and (2) address whether detected differences in metabolite levels were likely to be driven by genetic differences between IHPS cases and controls or by differences in early life feeding patterns. Methods We used population-based random selection of IHPS cases and controls born in Denmark between 1997 and 2014. We randomly took dried blood spots of newborns from 267 pairs of IHPS cases and controls matched by sex and day of birth. We used a mixed-effects linear regression model to evaluate associations between 148 metabolites and IHPS in a matched case–control design. Results The phosphatidylcholine PC(38:4) showed significantly lower levels in IHPS cases (P = 4.68 × 10−8) as did six other correlated metabolites (four phosphatidylcholines, acylcarnitine AC(2:0), and histidine). Associations were driven by 98 case–control pairs born before 2009, when median age at sampling was 6 days. No association was seen in 169 pairs born in 2009 or later, when median age at sampling was 2 days. More IHPS cases than controls had a diagnosis for neonatal difficulty in feeding at breast (P = 6.15 × 10−3). Genetic variants known to be associated with PC(38:4) levels did not associate with IHPS. Conclusions We detected lower levels of certain metabolites in IHPS, possibly reflecting different feeding patterns in the first days of life.

Risk of Infantile Hypertrophic Pyloric Stenosis after Maternal Postnatal Use of Macrolides

2003 ◽  
Vol 35 (2) ◽  
pp. 104-106 ◽  
Author(s):  
Henrik Toft Sørensen ◽  
Mette Vinther Skriver ◽  
Lars Pedersen ◽  
Helle Larsen ◽  
Finn Ebbesen ◽  
...  
Keyword(s):  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Infantile Hypertrophic Pyloric Stenosis
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