Neonatal Emergencies II: Infantile Hypertrophic Pyloric Stenosis & Intestinal Obstruction

This review focuses on the clinical presentation, diagnosis, preoperative stabilization and intraoperative management of infantile hypertrophic pyloric stenosis (IHPS) and neonatal gastrointestinal obstructions. IHPS poses medical emergency, which demands adequate preoperative optimization of the intravascular status and metabolic derangements before proceeding with surgery. In contrast, malrotation and volvulus require immediate surgical exploration under ongoing aggressive resuscitation in order to minimize further deterioration and preserve bowel length. Congenital anomalies, associated with disorders such as duodenal atresia, malrotation, volvulus, and anorectal malformations, warrant focused examinations to characterize the defect and severity of functional impairment, but they should not delay interventions for which time is a critical factor. This review contains 2 tables, and 41 references. Key words: neonatal, infantile pyloric stenosis, gastrointestinal, vomiting, metabolic, resuscitation, obstruction, malformation, apnea, rapid sequence.

Ultrasound and Infantile Pyloric Stenosis (IHPS) early Detection Better Patients

The role of ultrasound in the diagnosis of Infantile Hypertrophic Pyloric Stenosis (IHPS) can not be over emphasized. The easy availability of this reliable imaging modality may contribute to prompter diagnosis and early treatment. The author wishes to present comparison of two series, of 52 patients each, conducted in the same department, but five years apart. Spread over more than a decade our experience with IHPS patients has undergone dramatic changes, especially the diagnostic part of it. Salient features of the two studies will be highlighted. In addition the study will examine whether the easy access to ultrasound has affected the care of infants with pyloric stenosis.