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KMID : 0380319910480000103
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Journal of Korean Research Institute for Better Living
1991 Volume.48 No. 0 p.103 ~ p.108
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The Clinical Significance of Alkalosis, Hypochloremia and Hypokalemia in Infantile Hypertrophic Pyloric Stenosis Surgically Treated
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Abstract
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Fourty two young infants who had a full set of sreum electrolytes drawn on admission and were undergoing pyloromyotomy for infantile hypertrophic pyloric stenosis during 10 years of period from Jan. 1981 to Dec. 1990. were analysed to define the clinical differences between infants who were alkalotic, hypochloremic or hypokalemic and those who were not.
1) Among total 42 cases, male to female ratio was 6 : 1 with male predominance, mean age at admission was 39.3±6.5 days old, mean duration of illness was 12.6±8.6 days and the incidence of palpable pyloric mass was 85.7％.
2) The 42 cases were divided into nonalkalotic(A1≤29mEq/1, n=19) and alkalotic(B1＞29mEq/1, n=23) bicarbonate groups, nonhypochloremic(A_2≥98mEq/1, n=18) and hypochloremic(B_2＜98mEq/1, n=24) chloride groups and also nonhypokalemic(A_3≥4.1mEq/1, n=23) and hypokalemic(B_3＜4.1mEq/1, n=19) kalium groups.
3) The alkalotic, hypochloremic and hypokalemic groups(B1, B2,B3) were higher proportion of female patients, longer mean duration of illness, and lower mean serum Na, K, Cl levels.
4) But mean age on admission, incidence of palpable pyloric mass, postoperative clinical course, and mean serum bicarbonate levels were no defference according to serum electrolyte levels or acid-base balance.
5) The incidence of aciduria and concentrated uria were 16.7％ each and no difference according to serum electrolyte levels.
The author concludes that the determination of serum electrolytes at admission is clinically rather more useful to correct imbalanced fluid & electrolyte preoperatively and thus to aid in the prognosis postoperatively than to distinguish IHPS patients who have vomited longer and to aid in the diagnosis of IHPS.
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