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KMID : 0605919980040020149
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Journal of Korean Association of Pediatric Surgeons
1998 Volume.4 No. 2 p.149 ~ p.155
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Infantile Hypertrophic Pyloric Stenosis
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Kim In-Gu
Kim Sang-Yoon
Kim Shin-Gon
Kim Woo-Ki
Kim Jai-Eok
Kim Jae-Cheon
Kim Hyun-Hahk
Park Kwi-Won
Park Young-Sik
Park Woo-Hyun
Song Young-Tack
Yang Jung-Woo
Oh Soo-Myung
Yoo Su-Young
Lee Doo-Sun
Lee Myung-Duk
Lee Suk-Koo
Lee Sung-Cheol
Chang Soo-Il
Jung Sang-Young
Chung Eul-Sam
Jung Poong-Man
Choi Kum-Ja
Chio Soon-Ok
Choi Seung-Hoon
Heo Young-Soo
Hong Jeong
Hwang Eui-Ho
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Abstract
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Thirty three members of the Korean Association of Pediatric Surgeons were surveyed to determine the clinical manifestations and current management of infantile hypertrophic pyloric stenosis (IHPS). The members completed a registration form and a questionnaire that indicated their treatment preferences for patients treated during 1996. The response rate was 84.8 %, and 23 institutions participated. Three hundred and sixty-three cases of IHPS were analysed. The male to female ratio was 5.15: 1. The presenting symptoms were nonbilious vomiting in 363 cases(lOO %), palpable mass in the upper abdomen in 200 cases (55.1 %) and visible peristaltic waves in 67 cases(l8.5 %). Fluid therapy was done in 161 cases(44.4 %) for preoperative preparation. Twenty patients(5.5 %) were premature. There were 27 low birth weight babies(7.7 %). The onset of symptoms ranged from 1 to 14 weeks of age with a peak occurrence at 2 to 4 weeks of age. Two hundred and thirty-six cases( 66.6 %) presented within 4 weeks of age. There was one set of male twins and a family history of twins. The modes of feedings were: breast feeding; 69 cases(24.5 %), formula feeding; 176 cases( 62.4 %) and mixed feeding; 37 cases(l3.l %). The preferred diagnostic modalities were ultrasonography (US) 229 cases(63.l %), UGI series 27 cases(7.4 %) and US and UGI series combined 86 cases(23.7 %). Only 21 cases(5.8 %) were operated on without imaging study, ie. with positive physical finding. Perforation of the mucosa during pyloromytomy occurred in 5 cases. All were treated successfully with primary closure. Persistent vomiting over 2 weeks after operation were reported in 5 cases. Three wound infections, one aspiration pneumonia and one postoperative bleeding were reported. There was no mortality in 363 cases.
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KEYWORD
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Infantile hypertrophic pyloric stenosis,
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