The Clinical Features of Infantile Hypertrophic Pyloric Stenosis in Chinese Han Population: Analysis from 1998 to 2010

Abstract

ObjectiveTo investigate clinical features of infantile hypertrophic pyloric stenosis (IHPS) in Chinese Han population.MethodsThree hundred and sixteen hospitalized patients with IHPS from January 1998 to February 2010 were retrospectively reviewed, and data including patient's sex, onset age, other coexisting congenital defects, pyloric circular muscle thickness evaluated by ultrasonograph, serum electrolytes concentration, and results of arterial blood gas analysis on admission were collected. The patients were divided into two groups: the duration between first onset and admission less than or equal to 10 days (early onset group), and more than 10 days (late onset group). The results of arterial blood gas and serum electrolyte concentration were compared between the two groups.ResultsThere were 271 males and 45 females in 316 patients; the onset age ranged between 1 and 351 (26.5±26.6) days. The birth weight ranged between 1.6 and 4.5 (3.23±0.44) kilograms; coexisting congenital defects were found in 65 cases (20.6%). Pyloric circular muscle thickness was 4–8 (5.4±1.0) millimetres (mm). For the early onset group, the rates of hypokalemia, hypochloraemia and hypercapnia were significantly lower than those in the late onset group (18.67% VS 50%, P<0.0001; 46.03% VS 71.01%, P = 0.003; 56.58% VS 83.44%, P = 2.17×10−5; respectively).ConclusionsThe symptom duration in Chinese Han population was longer than that in other populations. And as the prolongation of symptom duration, the incidence of acid-base imbalance increased significantly. Infants with persistent vomiting at the age of 3∼5 weeks after birth should be considered IHPS, and go to hospital as soon as possible in order to reduce the incidence of hypokalemia, hypochloraemia and hypercapnia, and avoid deterioration.

Pathophysiology of Hypertrophic Pyloric Stenosis Revisited: The Use of Isotonic Fluid for Preoperative Infusion Therapy Is Supported

“…The pathogenesis of IHPS is multifactorial and includes hypergastrinemia, abnormal pyloric innervation, genetic mutations, and environmental influences [5] [14]. This study was performed in Nordrhein-Westfalen (NRW).…”

“…Most of the IHPS infants were mature with a normal gestation and age-appropriate birth weight[10] [17][18]. However, up to 1/4 of the patients were premature[9] [13][14]…”

Application of color Doppler ultrasound combined with Doppler imaging artifacts in the diagnosis and estimate of congenital hypertrophic pyloric stenosis

“…The incidence rate was approximately 2 to 5 per 1000 live births, with infants of affected parents at greater risk (2.5–20%). The risk is four times higher in boys than girls 2 , 3 . The pyloric hypertrophies after birth causes progressive gastric outlet obstruction and most commonly observed in infants between 2 and 6 weeks of age 4 .…”

<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.…”