Infantile hypertrophic pyloric stenosis: a 4-year experience from two tertiary care centres in Cameroon

Abstract

ObjectiveThis study aimed to describe the clinical characteristics of patients with infantile hypertrophic stenosis, management and its outcome in two tertiary care centres in Cameroon.ResultsA total of 21 patients were included from the two centres. The mean age at presentation was 5.2 ± 1.2 weeks, predominantly male with a male-to-female ratio of 4.25:1. The triad of vomiting, visible peristalsis and palpable mass was present in only 7 (33.3%) of the participants. The diagnosis was confirmed with ultrasounds in all participants. Ramstedt pyloromyotomy was done in all participants and in 9.5% of the participants it was complicated by intra-operative duodenal perforation whereas in the postoperative period the most common complications were vomiting (6, 28.6%), sepsis (2, 9.5%), and paralytic ileus (2, 9.5%). The mortality rate from the series is 9.5%. According to univariate logistic regression: severe dehydration [OR = 5.41, 95% CI = (3.11–6.97), p = 0.002], hypokalaemia [OR = 2.63, 95% CI = (1.02–5.91), p = 0.042] and surgical site infection [OR = 3.12, 95% CI (1.22–5.64), p = 0.023] were the main predictors of mortality whereas postoperative hospital length of stay > 5 days was significantly associated with surgical site infection [OR = 2.44, 95% CI = (1.12–6.44), p = 0.002] and postoperative nausea and vomiting [OR = 3.64, 95% CI = (1.18–6.64), p = 0.022].

Pyloric stenosis at a tertiary hospital in Uganda

“…All our patients had non-bilious vomiting, and this is consistent with various studies done all over the world, including in settings similar to ours [1,3].…”

“…Although, IHPS has been shown to occur in preterm babies [3], in our setting, none of the children diagnosed with IHPS were born preterm. This may be due to the low overall survival of preterm infants in our setting or failure to recognize and refer these infants as they often present atypically.…”

“…The exact etiology of pyloric stenosis is not well-defined but is likely multifactorial with genetic and environmental factors both playing a role. Hypertrophy of the smooth muscles of the pylorus results in narrowing of the lumen and eventually gastric outlet obstruction [3]. It characteristically presents as non-bilious vomiting in a baby and is often accompanied by severe electrolyte derangements, mainly hypochloremic, hypokalemic metabolic acidosis [1].…”

Congenital absence of lingual frenum in a non-syndromic patient: a case report

“…IHPS is the most common condition requiring surgical intervention during the first weeks of life [17, 18]. The reported incidence of IHPS is 3 in 1000 live births, with a male to female ratio ranging from 3:1 to 6:1 [19].…”

Yenidoğanda Uzamış Sarılığın Nadir ve Önemli Bir Sebebi: İnfantil Hipertrofik Pilor Stenozu

“…2,3 İnfantil hipertrofi k pilor stenozu (İHPS), pilorun düz kas lifl erinin hiperplazisiyle pilor kanalının daralması sonucunda oluşan mide çıkışı tıkanıklığıdır. 4 (string sign), antral "diş" (teeth) veya "omuz" (shouldering) bulgusu, antral "gaga" (beak sign) bulgusu, pilor kanalında "çift yol" (double track) bulgusu, duodenal bulbusta "şemsiye" (umbrella sign) bulgusu tanı koydurucu bulgulardır. 13…”