The management of hypertrophic pyloric stenosis at the Los Angeles Childrens Hospital

Pollock, William F.; Norris, William J.; Gordon, H. Earl

doi:10.1016/0002-9610(57)90662-1

Cited by 41 publications

(6 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prolonged hospital stay is caused by complications that occur in 10-20% of infants.2 16 Serious haemorrhage after pyloromyotomy tends to be played down and many authors suggest that no steps need be taken to control the bleeding, though such laxity has been criticised'5 and deaths from haemorrhage have been recorded. 4 Appreciable postoperative bleeding occurs in up to 7.5% of patients1 19 and after our salutary experience with one serious haemorrhage we have taken greater steps to secure haemostasis.…”

Section: Resultsmentioning

confidence: 99%

Recent results of treatment of infantile hypertrophic pyloric stenosis.

Zeidan

Wyatt

Mackersie

et al. 1988

Archives of Disease in Childhood

View full text Add to dashboard Cite

Section: Resultsmentioning

confidence: 99%

Recent results of treatment of infantile hypertrophic pyloric stenosis.

Zeidan

Wyatt

Mackersie

et al. 1988

Archives of Disease in Childhood

View full text Add to dashboard Cite

“…1,2 The presence of hypochloremic alkalosis has also been associated with IHPS. 3 Infants with historical but not physical findings consistent with IHPS undergo radiologic evaluation by either upper gastrointestinal series (UGI) or, more recently, abdominal ultrasound (U/S) to establish the diagnosis.…”

mentioning

confidence: 99%

Evolution in the Recognition of Infantile Hypertrophic Pyloric Stenosis

Hulka

Campbell

Campbell³

et al. 1997

Pediatrics

View full text Add to dashboard Cite

ABSTRACT. Purpose. To analyze changes in the clinical condition at presentation and methods of establishing the diagnosis of infantile hypertrophic pyloric stenosis (IHPS).Methods. Retrospective review of patients who underwent pyloromyotomy (PM) for suspected IHPS at two institutions from 1969 through 1994 was performed. For the purposes of comparison, the population was divided into five equal time periods.Results. Over the 25-year period, 901 infants underwent PM. Patients presented at a younger age, weighed more, and had a shorter length of illness in the most recent time period. Hypochloremic alkalosis was found half as frequently in the most recent time period compared to the earliest group. A palpable pyloric tumor was present in 79% of patients in the earliest time period compared with 23% in the most recent time period. Sixty-one percent of patients in the earliest group and 96% in the latest group underwent an imaging study, reflecting the referring physician's evaluation before referral to the surgeon.Conclusions. Currently, patients with IHPS less frequently present with the clinical hallmarks of the disease. The use of imaging studies to establish the diagnosis has become common practice. The result has been the diagnosis of IHPS before alkalosis has developed, a shorter clinical course, less morbidity, and a shorter postoperative hospital stay. Pediatrics 1997;100(2). URL: http://www.pediatrics.org/ cgi/content/full/100/2/e9; pyloric stenosis, pyloromyotomy, diagnosis, hypochloremic alkalosis, upper gastrointestinal series, abdominal ultrasonography.ABBREVIATIONS. IHPS, infantile hypertrophic pyloric stenosis; UGI, upper gastrointestinal series; U/S, ultrasound; PM, pyloromyotomy; PLOS, preoperative length of stay; TLOS, total length of stay.T raditionally, the diagnosis of infantile hypertrophic pyloric stenosis (IHPS) is based on a history of projectile, nonbilious vomiting, and palpation of a pyloric tumor.1,2 The presence of hypochloremic alkalosis has also been associated with IHPS.3 Infants with historical but not physical findings consistent with IHPS undergo radiologic evaluation by either upper gastrointestinal series (UGI) or, more recently, abdominal ultrasound (U/S) to establish the diagnosis. The increased reliance of radiologic tests to diagnose IHPS has been ascribed to inexperienced examiners not palpating a pyloric tumor and subsequently proceeding with further evaluation. 4 -6 To evaluate temporal trends in the presentation and methods of diagnosis of IHPS, we performed a review of patients who underwent pyloromyotomy (PM) in the past 25 years. PATIENTS AND METHODSA retrospective chart review of patients who underwent PM for suspected IHPS at two teaching institutions between 1969 and 1994 was performed. All patients were examined and subsequently operated on by one of the authors (T.J.C., J.R.C., M.W.H.). Only patients with confirmed IHPS at the time of surgery were included in this analysis. Data included demographic information, history of illness, physical findings, admission...

show abstract

“…Hypertrophic pyloric stenosis has been found in 6% to 12% of patients with other congenital malformations, such as oesophageal atresia, malrotation, diaphragmatic hernia, Meckel's diverticulum, anorectal anomalies, Hirschsprung's disease, hiatus hernia, inguinal hernia and umbilical hernia 3,45. A widely quoted study has also revealed a higher incidence (21%) of renal anomalies in infants with HPS compared to the neonatal population 6 (Table I).…”

Section: Associated Urological Anomalies In Infants With Hypertrophicmentioning

confidence: 99%

Is screening ultrasound of the urinary tract indicated in infants with hypertrophic pyloric stenosis?

Cascio¹,

Siddiqui²,

Barrett³

2005

Acta Paediatrica

View full text Add to dashboard Cite

Aim: Few retrospective studies have evaluated infants with hypertrophic pyloric stenosis (HPS) for associated urological anomalies. They have led to contradictory conclusions. The aim of this study was to evaluate the incidence of urinary tract anomalies in infants with HPS and to establish the clinical significance of this association. Methods: One hundred and twenty‐two infants (100 boys) who underwent pyloromyotomy between 1992 and 2002 were prospectively evaluated. Screening ultrasound (Us) of the urinary tract was performed in 107 infants, while 15 did not attend their ultrasound appointment. Results: Renal ultrasound was abnormal in 4 (4%) of 107 screened patients with HPS. Three patients were found to have mild hydronephrosis and, in one patient, a small, normal kidney was detected. Two patients with hydronephrosis had Us follow‐up and the third patient underwent Tc‐99 mercaptoacetyl triglycine (MAG 3) scan. In all three patients, the hydronephrosis resolved completely on follow‐up scan. Conclusion: The incidence of abnormal renal ultrasound in children with HPS is similar to the reported incidence of 3–6% determined with routine ultrasound screening of healthy newborns. The abnormalities detected were not clinically relevant and did not require surgical intervention. We do not recommend screening of the urinary tract in infants with HPS.

show abstract

The management of hypertrophic pyloric stenosis at the Los Angeles Childrens Hospital

Cited by 41 publications

References 29 publications

Recent results of treatment of infantile hypertrophic pyloric stenosis.

Recent results of treatment of infantile hypertrophic pyloric stenosis.

Evolution in the Recognition of Infantile Hypertrophic Pyloric Stenosis

Is screening ultrasound of the urinary tract indicated in infants with hypertrophic pyloric stenosis?

Contact Info

Product

Resources

About