Congenital hypertrophic pyloric stenosis is a frequent neonatal disease which is caused by marked hypertrophy of muscular layer in pylorus. Main clinical manifestations are non-bile stained projectile vomiting, visible peristaltic wave and olive-like mass, and it induces severe dehydration and metabolic derangement.
Proper preoperative management is required for dehydration and metabolic derangement and Fredet-Ramstedt Pyloromrotomy is widely used as a definitive surgical treatment.
The authors studied on 31 cases of congenital hypertrophic pyloric stenosis, treated at the Department of General surgery, Chungnam National University Hospital from July 1985 to June 1988.
The results were as follows :
1) The congenital hypertrophic pyloric stenosis was 31 cases which was 4.9% in incidence in total 638 admission to the department of pediatric surgry during the same period.
2) The most prevalent age group was between 5th week and 6th week and the ratio of male to female was 9 : 1.
3) Among 31 cases, breast-fed infants were 10 cases(29.1%), milk-fed 19 cases (58.3%), and mixed-fed 2 cases(6.5%).
4) The body weight percentile at admission was lower than 25 percentile in 31 cases and the body weight at admission was lower than birth weight in 6 cases(19.4%).
5) In 29.2%, clinical manifestations were noted between 2nd week and 3rd week.
6) Non-bile stained projectile vomiting was noted in 30 cases(96.8%).
7) The most frequent physical findings were pyloric mass(77.4%), visible peristaltic wave(45.4%)and jaundice(19.4%) in order of freguency.
8) At the time of admission, the accompanied jaundice was noted in 6 cases(19.4%) and most of them was breast-fed infants.
9) The higher the value of CO₂ content, the more severe hypochloremia and hypokalemia were noted.
10) The longer duration of symptoms, the more hypochloremic, hypokalemic metabolic alkalosis was noted.
11) In 6 cases(10.4%), associated anomalies were noted.
12) All 31 cases , were surgically treated with Fredet-Ramstedt pyloromyotomy and morta lity was nil.
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