Infantile hypertrophic pyloric stenosis: A clinical review from a general hospital

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Abstract
A review of 212 cases of infantile hypertrophic pyloric stenosis (IHPS) in a general hospital during an 8.5 year period documents clinical features and suggests refinement of treatment. Features such as sex, age at onset and presentation were similar to other studies. There was a preponderance of infants born in the summer. Premature infants represented 10% of the series, and the most premature (vs 25 days). Diagnosis was clinical in 65% of cases, but 4% presented before physical examination and diagnostic tests were positive. At the time of admission only 15% had significant abnormalities of serum electrolytes (chloride <85 mmol/L). The periumbilical incision resulted in a hidden scar. Duodenal perforation (3.3%) and wound dehiscence (1.4%) are related to technical factors and can be avoided. The timing of commencement of postoperative feeds did not influence the rate of vomiting. The average length of stay was 3.5 days. These results are discussed with suggestions about how to minimize diagnostic tests and length of hospital stay.