Is There a Relation Between Pyloric Muscle Thickness and Clinical and Laboratory Data in Infants with Hypertrophic Pyloric Stenosis?

Abstract

Literature about the association between clinical and laboratory presentation and pyloric muscle thickness in infants with pyloric stenosis is lacking. The objective of this study is to examine the effect of pyloric muscle thickness on clinical and laboratory presentation in infants with pyloric stenosis. Thirty infants with hypertrophic pyloric stenosis presented at the Maternity and Children Hospital, AlMadinah, Saudi Arabia, were included in this study analysis. Clinical and laboratory data of these infants were recorded. Statistical tests and univariate linear regression analyses were used as appropriate. P value was considered significant at a level ≤0.05. The mean age of the studied infant was 5.1± 2.6 weeks and mean weight was 3.4±0.7 kg. Most of these infants were full-term (93.3 %), some presented to the hospital dehydrated (80 %), and some were lethargic (56.7 %). The mean pyloric muscle thickness among these infants showed statistically significant difference with regard to the studied clinical and laboratory data. A linear regression analyses also showed positive association between increasing pyloric muscle thickness and almost all studied clinical and laboratory data, with statistically significant difference observed for hyponatremia, hypochloremia, and high bicarbonates. The findings suggest that pyloric muscle thickness is a significant factor that determines the severity of clinical and laboratory presentation in infants with pyloric stenosis.

Open Versus Laparoscopic Pyloromyotomy for Pyloric Stenosis—A Systematic Review and Meta-Analysis

“…4 Gastric outlet obstruction causes vomiting leading to electrolyte disturbances, dehydration, and failure to thrive. 5,6 The gold standard in treatment of IHPS consists of a longitudinal seromuscular incision along the entire length of the hypertrophic muscle resulting the unharmed mucosa to bulge through the incision. [7][8][9] Laparoscopic surgery was developed by Kurt Semm in the 1980s.…”

Utility of Pyloric Length Measurement for Detecting Severe Metabolic Alkalosis in Infants with Hypertrophic Pyloric Stenosis

“…Therefore, it is important to recognize IHPS early and treat it accordingly with fluid resuscitation [ 18 ]. In previous studies, ultrasonographic detection of increased pyloric muscle thickness was found to be associated with biochemical parameters, including metabolic alkalosis [ 6 19 ]. This relationship may be explained by persistent vomiting caused by gastric outlet narrowing due to increased muscle thickness.…”

“…Hypochloremia with metabolic alkalosis is a typical laboratory finding that results from the loss of gastric hydrochloric acid. A recent study reported a positive correlation between symptom duration and serum bicarbonate levels [ 5 ] and another study reported that pyloric muscle thickness is a significant factor for dehydration and high bicarbonate levels in infants with IHPS [ 6 ]. Normalization of metabolic derangement by fluid rehydration is important for avoiding complications after operation, such as apnea [ 7 ].…”

<p>Pyloromyotomy in Hypertrophic Pyloric Stenosis: A Comparative Study Between Supraumbilical Curved Skin Incision and Standard (Right Upper Quadrant) Skin Incision: Study in a Resource Limited Setting</p>

“…1 The incidence of HPS is approximately 2 to 5 cases per 1000 live births, which is four times higher in male gender as compared to girls. [2][3][4] The other main clinical symptoms except vomiting included visible peristaltic waves and olive-shaped lumps and finally causes severe malnutrition and death. Therefore, for a better prognosis results, early treatment is required.…”