Hypertrophic pyloric stenosis in infants: is it a congenital or acquired disorder? Reflections on 2 cases

Tambo, F.F. Mouafo; Tsala, I.N. Kouna; Ngowe, Marcelin Ngowe; Ondobo, Gervais Andze; Sosso, Maurice Aurélien

doi:10.1186/2193-1801-3-555

Cited by 2 publications

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References 6 publications

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“…Morbidity and complications are often serious and life-threatening secondary to physiological disorders. Mortality from neonatal surgery was reported as 48% in Cameroon and 62.2% in Nigeria [8,9]. In Rwanda, there are 36 district hospitals, 4 provincial hospitals, and 8 referral hospitals.…”

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confidence: 99%

Neonatal surgical mortality and morbidity at the University Teaching Hospital of Kigali, a tertiary university hospital in Rwanda: analysis of predicting factors

Maniraguha,

Robin,

Richard

et al. 2023

rmj

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INTRODUCTION: Globally, high morbidity and mortality is associated with neonatal surgicalconditions. This study aimed to determine the factors influencing the mortality in neonates withsurgical conditions at Centre Hospitalier Universitaire de Kigali (CHUK).METHOD: This was a prospective study from October 2019 to March 2020. Analysis of patientswas divided based on a diagnosis of gastroschisis versus non-gastroschisis conditions. Odds ratioswere calculated at a confidence interval of 95%. Factors with p-value <0.05 on bivariate analysiswere considered.RESULTS: Eighty-two neonates were enrolled. 45.1% were admitted within the first 24 hours of life,61% were males, 26.9% were preterm, and 51.2% had birth weight less than 2500g. Gastroschisis(n=43, 52.4%) was the most common diagnosis, followed by intestinal atresia (12.2%). The overallmortality rate was 57%. Mortality was more likely to occur among neonates with gastroschisiscompared to neonates with non-gastroschisis surgical conditions (76.7% vs 35.9%, OR=5.893,p<0.001). Among neonates with gastroschisis, factors associated with mortality were the failureof initiation of enteral feeding (100%, p=0.002) and sepsis (82.5%, p=0.001).Among neonates with non-gastroschisis surgical conditions, factors associated with mortalitywere prematurity (87.5%, OR:24, p=0.001), low birth weight (72.7% vs 21.4%, p=0.003), initiationof enteral feeding at more than 48 hours (33.3% vs 25.8%, p=0.006), sepsis (64.7% vs 13.6%,OR:11.61, p<0.001), and need of mechanical ventilation (63.6% vs 25%, OR:5.25, p=0.024,).CONCLUSION: Neonatal surgical mortality is still a burden and has many predicting factors.Improvement and advocacy are needed to reduce neonatal mortality.

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Section: Introductionmentioning

confidence: 99%

Neonatal surgical mortality and morbidity at the University Teaching Hospital of Kigali, a tertiary university hospital in Rwanda: analysis of predicting factors

Maniraguha,

Robin,

Richard

et al. 2023

rmj

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Trends in the publication of infantile hypertrophic pyloric stenosis in Africa: A systematic review

Ogundoyin

Ajao

2021

ANMRP

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There are still global variations in the epidemiology of infantile hypertrophic pyloric stenosis, although the clinical presentations may be similar. Outcome of management, however, may depend on the degree of evolution of management of the anomaly. This review aimed at evaluating the trends of reporting of infantile hypertrophic pyloric stenosis from Africa. An evaluation of all publications from Africa on infantile hypertrophic pyloric stenosis focusing on epidemiology, evolution of management of the anomaly was carried out. Literature search of all publications from Africa on Infantile hypertrophic pyloric stenosis was conducted from January 1, 1951, to December 31, 2018. The articles were sourced from the databases of African Index Medicus, OvidSP, PubMed, African Journal Online, and Google Scholar. Extracted from these publications were information on the type of article, trend of reporting, the country of publication, demographic details of the patients, number of cases, clinical presentation, pre-operative management, type of surgical approach, and the outcome of management. Overall, 40 articles were published from 11 countries. Of these, 16 (40.0%) were published in the first 35 years (Group A, 1951–1985) and 24 (60.0%) published in the later 33 years (Group B, 1986– 2018). Case reports 8 (20.0%) and case series 5 (12.5%) were predominant in Group A, whereas retrospective studies 12 (30.0%) predominated in Group B. The countries of publication included Nigeria (27.5%), South Africa (15.0%), Egypt (12.5%), Tanzania (10.0%), and Zimbabwe (10.0%). A total of 811 patients diagnosed and managed for infantile hypertrophic pyloric stenosis (IHPS) were reported. Their ages ranged from 1 day to 1 year with an incidence that ranged from 1 in 550 to 12.9 in 1000. There were 621 boys and 114 girls (M:F – 5.5:1). All the patients were breastfed with an average birth rank incidence of 42.4% among firstborns, 19.5% in second borns, 15.2% in third borns, 13.2% among fourth borns, and 10.0% among fifth borns and beyond. Associated congenital anomalies were reported in 5 (12.5%) studies with an incidence of 6.9–20% occurring in a total of 28 patients. All but 3 (7.5%) studies reported that open surgery was adopted to perform Ramstedt’s pyloromyotomy on the patients. Reported post-operative complications include mucosal perforation in 8 (20.0%) studies, surgical site infection in 7 (17.5%), gastroduodenal tear 2 (5.0%), and hemorrhage and incisional hernia in 1 (2.5%) study each. Mortality was reported in 26 (65.0%) studies with a range of 1.8–50% and a mean mortality rate of 5.2%. There has been a change in the trend of reporting IHPS in Africa over the years, with increasing comparative studies on the modalities of management compared to case reports and series. Still very limited work has been done in the aspect of genetics and etiology of IHPS among Africans. There is a need to increase funding in this regard and to encourage multi-center collaborations in the study of this relatively rare condition.

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Hypertrophic pyloric stenosis in infants: is it a congenital or acquired disorder? Reflections on 2 cases

Cited by 2 publications

References 6 publications

Neonatal surgical mortality and morbidity at the University Teaching Hospital of Kigali, a tertiary university hospital in Rwanda: analysis of predicting factors

Neonatal surgical mortality and morbidity at the University Teaching Hospital of Kigali, a tertiary university hospital in Rwanda: analysis of predicting factors

Trends in the publication of infantile hypertrophic pyloric stenosis in Africa: A systematic review

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