Demography and Ultrasound Measures in Infantile Hypertrophic Pyloric Stenosis - Our Institutional Experience

Abstract

Infantile hypertrophic pyloric stenosis (IHPS) is most common surgical cause of non-bilious vomiting in infants. This study describes the clinical presentation, diagnosis, management and outcome of management of infants with IHPS and identifies the factors responsible for poor outcome in these patients. Methods and Materials: This is a prospective study. It was conducted between September 2018 to April 2020 at J. K. Lone Hospital, SMS Medical College Jaipur, and Rajasthan, India. Results: A total 80 patients (M: F=4.7:1) were studied with male predominance. Mean age of presentation was 6.26 weeks. Maximum 47.5% (38) patients present in age group of >4-8 weeks. Clinical presentation with a triad of non-bilious projectile vomiting, visible gastric peristalsis and palpable Olive tumor was present in 62.5 % (50) patients. Non bilious vomiting was the most common presenting symptom, present in 100% (80) patients. Mean hospital stay was 4.23 days. Serum electrolytes disturbance was present in 61.5% (49) patients. The surgery was Ramstedt's pyloromyotomy done in all cases. Mortality rate was 3.75%.Thickness of pyloric muscles was increasing in proportional ratio with age. Conclusion: In this study delayed presentation and Serum electrolytes imbalance are most common causes of poor outcome. USG abdomen is best imaging modality for confirmation of diagnosis. Pyloric muscle wall thickness showed relation with age in proportional increasing pattern.