Pyloric Stenosis

1990 ◽  
Vol 11 (10) ◽  
pp. 296-310
Keyword(s):  
New Jersey ◽  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Pyloric Muscle

The pyloric muscle dimensions of 1400 consecutive newborns were measured at birth (ie, prospectively) by ultrasonography. Nine infants subsequently developed pyloric stenosis. All diagnoses were proved at surgery. The pyloric measurements of the infants with pyloric stenosis did not differ from normal at birth, but there was significant increase at the time of diagnosis. "We conclude that infantile hypertrophic pyloric stenosis should no longer be referred to as `congenital' pyloric stenosis, although the true etiology of this acquired condition remains to be elucidated." (Richard H. Rapkin, MD, Children's Hospital of New Jersey)

Sonography and Test-Feeding in the Diagnosis of Infantile Hypertrophic Pyloric Stenosis

2020 ◽  
Vol 37 (1) ◽  
pp. 25-30
Author(s):  
Syed Amir Gilani ◽  
Raham Bacha ◽  
Iqra Manzoor
Keyword(s):  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Clinical Signs ◽  
Muscle Thickness ◽  
Male Gender ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Study Duration ◽  
The Mean ◽  
Pyloric Muscle ◽  
Better Than

Objective: To determine the use of sonography and test-feeding in the diagnosis of infantile hypertrophic pyloric stenosis (IHPS). Methodology: A total of 79 infants from 2 weeks up to 12 weeks presenting with clinical signs (projectile vomiting) of IHPS were included in the study while sent to sonography. The study duration was February 2014 to December 2019. Results: The mean age of patients was 5.18 ± 2.69 weeks ranging from 1 to 12 weeks. Male gender was predominant with 62 (78.5%) cases. Of the total 79 cases, 36 (54.6%) were suggested as positive cases of IHPS and 43 (54.4%) were as normal with sonography. Most of the cases of IHPS (23; 29.1%) were observed in firstborn babies. Mean pyloric length in normal and IHPS was 12.69 ± 0.87 and 20.78 ± 2.28 mm, respectively, and mean pyloric muscle thickness in the normal and IHPS was 2.24 ± 0.36 and 5.27 ± 0.82 mm, respectively, while mean pyloric diameter in normal and IHPS was 12.69 ±0.87 and 15.01± 2.52 mm, respectively. Conclusion: The reliability of sonographic findings was better than test-feeding in the diagnosis of IHPS. Male infants, in this cohort, were five times more susceptible to develop IHPS, compared with females.

scholarly journals The use of ultrasonography in infantile hypertrophic pyloric stenosis: do the patient’s age and weight affect pyloric size and pyloric ratio?

2015 ◽  
Vol 17 (1) ◽  
pp. 28 ◽  
Author(s):  
Umit Yasar Ayaz ◽  
Mehmet Ercüment Döğen ◽  
Alper Dilli ◽  
Sevin Ayaz ◽  
Arman Api
Keyword(s):  
Retrospective Study ◽  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Muscle Thickness ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Term Infants ◽  
Lower Weight ◽  
Age Dependent ◽  
The Mean ◽  
Pyloric Muscle

Aims: We aimed to obtain pyloric measurements of our patients with infantile hypertrophic pyloric stenosis (IHPS) using ultrasonography (US) and to evaluate the correlations between age, weight and pyloric size, pyloric ratio (PR). Material and methods: We designed a retrospective study including 20 term infants with surgically proven IHPS and studied the ultrasono- graphically obtained pyloric muscle thickness (PMT), pyloric diameter (width) (PD), pyloric length (PL) and PR (PMT/PD) to determine if there were statistically significant associations between patient age/weight and pyloric measurements. Results: The mean age of the infants was 38.7±17.3 days (range, 9–76 days) and their mean weight was 3688.5±772.7 g (range, 2810– 6000 g), at referral. Mean PMT was 4.98±1.04 mm (range, 3.5–6.8 mm). Mean PD was 14.04±2.39 mm (range, 10–18 mm). Mean PL was 22.16±4.02 mm (range, 16–31.5 mm) and mean PR was 0.35±0.04 (range, 0.29–0.42). The correlation between age and PMT (r=0.654, p0.05). Conclusions: The PMT and PD are age dependent parameters. The PR is age and weight independent and therefore, when combined with PMT, PD and PL, it can be useful in the diagnosis of IHPS in infants with early onset disease and/or in those with a lower weight.

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

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