[Retrospective study of congenital hypertrophic pyloric stenosis and pylorospasm: Surgical vs. non-surgical treatment (author's transl)].

  • 1 June 1975
    • journal article
    • research article
    • Vol. 123  (6) , 503-8
Abstract
Congenital hypertrophic pyloric stenosis and pylorospasm have extensively been studied in 705 infants treated in 5 pediatric clinics in Hamburg, W.-Germany, during 1961 to 1970. With this report and its statistical evaluation we are aiming to provide basical information to answer the question still open to discussion: Are we allowed to demand surgical treatment in every single case of spastic hypertrophic pyloric stenosis? The following questions have been investigated: distribution of cases due to grade of severity; frequency of surgical and non-surgical, conservative treatment in these groups of different severity; its rate of success and of fatal outcome; length of clinical treatment and hospitalization; frequency of additional, intercurrent disease in both groups, with and without abdominal surgery; complications during and after surgery; late complications with regard to the way of treatment. From our results we conclude that surgical intervention is indicated in severe cases and in cases of medium severity, together amounting to 60% of all cases. In less severe, about 40%, cases non-surgical, conservative treatment is promising in almost all cases. The most important parameter to single out these less severe cases besides the general status is the roetgenologic finding that delayed emptying of the stomach starts within 15 to 20 min. Important as well is a balanced electrolyte and acid-base metabolism. Once more we advocate individual and subtle decision of paramount surgical intervention, reasoning from the background of this study where the percentage of infants successfully treated by non-surgical, conservative medical ways is very high.

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