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Aslam H, Lane M, Alverson B. It is Not Just Bad Luck: A Case Report Exploring Pyloric Stenosis in Twins. Clin Pediatr (Phila) 2024:99228241234211. [PMID: 38400725 DOI: 10.1177/00099228241234211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2024]
Affiliation(s)
- Hira Aslam
- Nemours Children's Hospital, Delaware, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Maria Lane
- Nemours Children's Hospital, Delaware, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Brian Alverson
- Nemours Children's Hospital, Delaware, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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Skarentzos K, Aggelidou M, Savas D, Bekiaridou K, Kambouri K. Hypertrophic pyloric stenosis case series in twins and first cousins: genes, feeding patterns or both? (a case report). Pan Afr Med J 2021; 39:210. [PMID: 34603591 PMCID: PMC8464213 DOI: 10.11604/pamj.2021.39.210.29180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 07/06/2021] [Indexed: 12/04/2022] Open
Abstract
We present two cases of dizygotic male twins and two cases of male first cousins with infantile hypertrophic pyloric stenosis (IHPS). All patients were treated with open pyloromyotomy. No complications were reported. The patients had the same risk factors for IHPS. First, all patients were first-born white males. Second, the twins were preterm (35 weeks). Third, the twins and the first cousins were exclusively bottle feeding. Thus, a combination of genetic and environmental factors may have contributed to the appearance of IHPS.
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Affiliation(s)
- Konstantinos Skarentzos
- Democritus University of Thrace, Department of Medicine, General University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Maria Aggelidou
- Democritus University of Thrace, Department of Paediatric Surgery, General University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Deftereos Savas
- Democritus University of Thrace, Department of Radiology, General University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Konstantina Bekiaridou
- Democritus University of Thrace, Department of Paediatric Surgery, General University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Katerina Kambouri
- Democritus University of Thrace, Department of Paediatric Surgery, General University Hospital of Alexandroupolis, Alexandroupolis, Greece
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Infantile hypertrophic pyloric stenosis in monozygotic twins. ANNALS OF PEDIATRIC SURGERY 2018. [DOI: 10.1097/01.xps.0000535044.67856.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Badebarin D, Aslanabadi S, Yazdanpanah F, Zarrintan S. Is there any correlation between radiologic findings and eradication of symptoms after pyloromyotomy in hypertrophic pyloric stenosis? Afr J Paediatr Surg 2016; 13:73-5. [PMID: 27251656 PMCID: PMC4955443 DOI: 10.4103/0189-6725.182560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Hypertrophic pyloric stenosis (HPS) is one of the most common gastrointestinal disorders during early infancy, with an incidence of 1-2:1000 live births in the world. In this study, we aimed to investigate the correlation between radiologic findings and eradication of symptoms after pyloromyotomy in HPS. MATERIALS AND METHODS One hundred and twenty-five (102 boys and 23 girls) patients with suspected infantile HPS were treated surgically by Ramstedt pyloromyotomy between March 21, 2004 and March 20, 2014 at paediatric surgery ward of Tabriz Children's Hospital, Iran. The demographic features, clinical findings, diagnostic work-up, operation type and postoperative specifications of the patients were studied retrospectively. RESULTS Male to female ratio was 4:1. The patients were 16-90 days of old and the mean age was 39 ± 1.42 days. The range of pyloric canal length was 7.60-29.00 mm and the mean length was 19.54 ± 3.42 mm. Pyloric muscle diameter was 2.70-9.00 mm, and the mean diameter was 4.86 ± 1.14 mm. Seventy-two percent of patients had episodes of vomiting after operation. Mean time of persistence of vomiting after pyloromyotomy was 15.73 ± 0.15 h. Mean discharge time was 55.22 ± 0.08 h. Radiologic findings did not show any significant correlation with persistence of vomiting or discharge time. CONCLUSION The present study revealed that radiographic findings could not predict postoperative symptom eradication after pyloromyotomy in HPS.
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Affiliation(s)
- Davoud Badebarin
- Division of Pediatric Surgery, Children's Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeid Aslanabadi
- Division of Pediatric Surgery, Children's Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fereshteh Yazdanpanah
- Department of Surgery, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sina Zarrintan
- Division of Pediatric Surgery, Children's Hospital; Department of General and Vascular Surgery, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
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Vermes G, László D, Czeizel AE, Ács N. Maternal factors in the origin of infantile hypertrophic pyloric stenosis: A population-based case-control study. Congenit Anom (Kyoto) 2016; 56:65-72. [PMID: 26394719 DOI: 10.1111/cga.12134] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 09/09/2015] [Indexed: 02/06/2023]
Abstract
In most patients affected by isolated infantile hypertrophic pyloric stenosis (IHPS) the etiology is largely unknown. Thus, the aim of this study was to estimate possible maternal risk factors in the origin of IHPS. The study samples included 241 cases with IHPS, 357 matched controls and 38,151 population controls without any defect in the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996. Exposures that had been medically recorded in prenatal maternity logbooks during the critical period of IHPS were evaluated separately. The findings of this case-control study suggested that--beyond the well-known robust male excess (85.5%)--maternal hyperthyroidism (OR with 95% CI: 4.17, 1.53-11.38) and oral nalidixic acid treatment (OR with 95% CI: 6.53, 3.03-14.06) associated with a higher risk for IHPS in their children. In conclusion, our findings suggest that cases with IHPS had mothers with a higher proportion of hyperthyroidism and nalidixic acid treatment during pregnancy.
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Affiliation(s)
- Gabor Vermes
- Department of Obstetrics and Gynecology, Military Hospital - State Health Centre, Budapest, Hungary
| | - Daniel László
- Department of Obstetrics and Gynecology, St. Stephen's Hospital, Budapest, Hungary
| | - Andrew E Czeizel
- Foundation for the Community Control of Hereditary Diseases, Budapest, Hungary
| | - Nándor Ács
- 2nd Department of Obstetrics and Gynecology, Semmelweis University School of Medicine, Budapest, Hungary
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Vermes G, Mátrai Á, Czeizel AE, Ács N. Birth outcomes of male and female patients with infantile hypertrophic pyloric stenosis--a population-based case-control study. J Matern Fetal Neonatal Med 2015; 29:1777-82. [PMID: 26135791 DOI: 10.3109/14767058.2015.1063606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Most of the patients are affected by isolated infantile hypertrophic pyloric stenosis (IHPS) beyond the polygenic predisposition, the other factors in the multifactorial etiology are largely unknown. The main characteristic of IHPS is the robust male predominance, thus the aim of this study was to analyze birth outcomes in males and females whether they are different or not. METHODS The study samples included 241 cases with IHPS, 357 matched, and 38,151 population controls without any defect in the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996. RESULTS The findings of this case-control study confirmed the well-known strong male excess (85.5%). The mean gestational age was somewhat longer and it is associated with a lower rate of preterm births. Mean birth weight did not show significant differences among the study groups, but the rate of low birthweight was higher in cases with IHPS. However, these differences were found only in males. Thus, intrauterine fetal growth restriction is characteristic only for male cases with IHPS. CONCLUSIONS Our study confirmed the well-known obvious male excess of cases with IHPS, but our findings suggest some differences in birth outcomes of male and female cases. Male cases with IHPS had intrauterine fetal growth restriction while females did not. These data may indicate some differences in the pathogenesis of IHPS in males and females.
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Affiliation(s)
- Gabor Vermes
- a Department of Obstetrics and Gynecology , Military Hospital - State Health Centre , Budapest , Hungary
| | - Ákos Mátrai
- b 2nd Department of Obstetrics and Gynecology , Semmelweis University , Budapest , Hungary , and
| | - Andrew E Czeizel
- c Foundation for the Community Control of Hereditary Diseases , Budapest , Hungary
| | - Nándor Ács
- b 2nd Department of Obstetrics and Gynecology , Semmelweis University , Budapest , Hungary , and
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Gezer HÖ, Oguzkurt P, Temiz A, Hicsonmez A. Hypertrophic pyloric stenosis in twins; genetic or environmental factors. Clin Genet 2014; 87:388-91. [PMID: 24724922 DOI: 10.1111/cge.12399] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 04/03/2014] [Accepted: 04/04/2014] [Indexed: 11/27/2022]
Abstract
The etiology of infantile hypertrophic pyloric stenosis (IHPS) remains obscure. Over 120 years after the condition has become a clinical entity the debate whether the cause of IHPS is genetic, environmental or both, has not yet reached a final conclusion. Herein, we present a pair of monozygotic male twins with IHPS together with a review of the literature. We aimed to support genetic pre-disposition in the epidemiology of IHPS, adding a twin data to the literature and to review the associated articles about the pathogenesis and inheritance patterns.
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Affiliation(s)
- H Ö Gezer
- Başkent University Faculty of Medicine, Department of Pediatric Surgery, Ankara, Turkey
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The clinical features of infantile hypertrophic pyloric stenosis in Chinese Han population: analysis from 1998 to 2010. PLoS One 2014; 9:e88925. [PMID: 24586444 PMCID: PMC3929628 DOI: 10.1371/journal.pone.0088925] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 01/14/2014] [Indexed: 11/27/2022] Open
Abstract
Objective To investigate clinical features of infantile hypertrophic pyloric stenosis (IHPS) in Chinese Han population. Methods Three 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. Results There 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). Conclusions The 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.
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Abstract
Infantile hypertrophic pyloric stenosis (IHPS) is a common condition in neonates that is characterized by an acquired narrowing of the pylorus. The aetiology of isolated IHPS is still largely unknown. Classic genetic studies have demonstrated an increased risk in families of affected infants. Several genetic studies in groups of individuals with isolated IHPS have identified chromosomal regions linked to the condition; however, these associations could usually not be confirmed in subsequent cohorts, suggesting considerable genetic heterogeneity. IHPS is associated with many clinical syndromes that have known causative mutations. Patients with syndromes associated with IHPS can be considered as having an extreme phenotype of IHPS and studying these patients will be instrumental in finding causes of isolated IHPS. Possible pathways in syndromic IHPS include: (neuro)muscular disorders; connective tissue disorders; metabolic disorders; intracellular signalling pathway disturbances; intercellular communication disturbances; ciliopathies; DNA-repair disturbances; transcription regulation disorders; MAPK-pathway disturbances; lymphatic abnormalities; and environmental factors. Future research should focus on linkage analysis and next-generation molecular techniques in well-defined families with multiple affected members. Studies will have an increased chance of success if detailed phenotyping is applied and if knowledge about the various possible causative pathways is used in evaluating results.
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de Laffolie J, Turial S, Heckmann M, Zimmer KP, Schier F. Decline in infantile hypertrophic pyloric stenosis in Germany in 2000-2008. Pediatrics 2012; 129:e901-6. [PMID: 22430445 DOI: 10.1542/peds.2011-2845] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The incidence of infantile hypertrophic pyloric stenosis (IHPS) is highly variable over time and geographic regions. A decline in IHPS incidence was recently reported in Sweden, the United States, Denmark, and Scotland. In Sweden, the IHPS decline seemed to be concurrent with a declining incidence in sudden infant death syndrome (SIDS), which suggested a common cause; the latter was attributed to campaigns against the prone sleeping position. We investigated the time course of the IHPS incidence in all German federal states (N = 16) between 2000 and 2008. We examined correlations between the IHPS incidence and the SIDS incidence. METHODS Data were extracted from the public report of health (Gesundheitsberichterstattung des Bundes). We collected the numbers of IHPS (International Classification of Diseases, 10th Revision [ICD-10], code 40.0), SIDS (ICD-10, R95), and live births (LB; male/female) in each federal state for 2000-2008. RESULTS The IHPS incidence declined in Germany from 2000 (3.2086/1000 LB [range: 1.67-5.33]) to 2008 (2.0175/1000 LB [1.74-3.72]; P = .005). The recorded incidence was highly variable in different federal states and over time. The SIDS incidence also declined during the same time period (2000, median: 0.759/1000 LB [interquartile range: 0.54-1.029]; 2008, median: 0.416/1000 LB [interquartile range: 0.285-0.6485]; P = .0255). However, the SIDS regional distribution was different from that of IHPS. CONCLUSIONS The IHPS incidence declined by ∼38% nationwide. A parallel decline in SIDS displayed a different pattern in regional distribution; thus, a common cause was unlikely. The regional differences indicated that etiologic factors remained unresolved.
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Affiliation(s)
- Jan de Laffolie
- Children's Hospital, Department of General Pediatrics and Neonatology, University of Giessen, Giessen, Germany.
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Tang KS, Huang IF, Shih HH, Huang YH, Wu CH, Lu CC, Huang FC, Tiao MM, Liang CD. Factors contributing to prolonged hospitalization of patients with infantile hypertrophic pyloric stenosis. Pediatr Neonatol 2011; 52:203-7. [PMID: 21835365 DOI: 10.1016/j.pedneo.2011.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Revised: 08/09/2010] [Accepted: 08/30/2010] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND To study the influence of clinical audit on diagnosis, complications, and factors contributing to hospitalization of patients with infantile hypertrophic pyloric stenosis. STUDY DESIGN Retrospective cohort study. METHOD There were 214 patients from 1991 to 2004 from three medical centers in Kaohsiung. Data were analyzed with respect to diagnostic methods, complications, and factors requiring patient hospitalization. RESULTS The ratio of male to female was 4.8:1 (177 males and 37 females). The diagnoses before admission were as follows: 22% had milk intolerance and 14.5% had esophageal reflux. There was a significant increase in the use of sonogram diagnostic test (p=0.005) and a decrease in the incidence of diagnosis by olive mass palpation but not by barium meal test. Surgery time of 48 hours after admission was significant with barium meal examination and related to longer hospital stay (p<0.001). Weight gain less than 800 g before admission (n=125) was related to longer hospital stay (p=0.026). CONCLUSION The diagnostic method was changed from olive mass palpation to sonogram. Weight gain less than 800 g before admission and surgery time of 48 hours after admission were related to longer hospital stay.
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Affiliation(s)
- Kuo-Shu Tang
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Mcheik JN, Dichamp I, Levard G, Ragot S, Beby-Defaux A, Grosos C, Couvrat V, Agius G. Infantile hypertrophic pyloric stenosis: are viruses involved? J Med Virol 2011; 82:2087-91. [PMID: 20981797 PMCID: PMC7167076 DOI: 10.1002/jmv.21913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Infantile hypertrophic pyloric stenosis (IHPS) is characterized by abnormal thickening of the internal circular muscle layer. IHPS is known to be due to a combination of genetic and environmental factors, but its precise causes and pathophysiology are poorly understood. The objective of the study is to determine the prevalence of the principal viruses targeting the respiratory and digestive tracts in children with IHPS. Nasopharyngeal fluids, stools, vomit, and surgical pyloric muscle fragments and swabs were tested by cell culture, viral antigen assay and PCR. IHPS was diagnosed in 23 boys and 8 girls with a mean (±SD) age of 42 ± 15 days (range 20–88 days). There was no seasonal pattern of diagnosis. Twenty‐two children (71%) lost weight (mean 246 ± 164 g, range 30–600 g) after the onset of vomiting, and five (16.1%) were dehydrated. Seven (22.6%) infants had been exposed to an infectious contact within 15 days before admission, and one on the day of admission (3.2%). Ear, nose and throat samples and pyloric muscle specimens were negative for all the viruses tested. An adenovirus type 3 was recovered from one stool sample, and RT‐PCR was positive for an enterovirus on one vomit sample. This study suggests that the principal viruses targeting the respiratory and digestive tracts are not responsible for IHPS. J. Med. Virol. 82:2087–2091, 2010. © 2010 Wiley‐Liss, Inc.
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Affiliation(s)
- Jiad N Mcheik
- Department of Pediatric Surgery, University Hospital, Poitiers, France
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Huang IF, Tiao MM, Chiou CC, Shih HH, Hu HH, Ruiz JP. Infantile hypertrophic pyloric stenosis before 3 weeks of age in infants and preterm babies. Pediatr Int 2011; 53:18-23. [PMID: 20557472 DOI: 10.1111/j.1442-200x.2010.03185.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Most infantile hypertrophic pyloric stenosis (IHPS) cases are diagnosed between 3 and 12 weeks after birth. Few data exist regarding Asian infants with IHPS who are younger than 3 weeks or are preterm. The goal of this study is to identify unusual clinical manifestations, clinical course, duration of hospital stay, and complications of Asian infants with IHPS who are preterm or younger than 3 weeks of age. METHODS From 1991 to 2004, all IHPS patients admitted to three tertiary centers in southern Taiwan were enrolled. The clinical manifestations, duration of hospital stay and complications were further compared between the IHPS patients diagnosed before and after 3 weeks; preterm and term infants. RESULTS A total of 214 patients were enrolled into the study; the mean age of diagnosis was 40 days of age; the average duration of hospital stay was 6.27 days. Eighteen (8.41%) patients were diagnosed before 3 weeks of age. A significantly shorter timeframe of diagnosis, a higher rate of jaundice, a lower daily body weight gain and longer duration of hospital stay were noted in the IHPS group prior to 3 weeks compared with those in IHPS group after 3 weeks. Eighteen were preterm infants. A significantly older age of symptom onset, a lower body weight at admission, more cases diagnosed by barium meal study and higher postoperative complication rates were noted in the preterm group versus full-term infants with IHPS. CONCLUSIONS The IHPS cases diagnosed before 3 weeks of age had longer duration of hospital stay. Preterm infants with IHPS had more postoperative complications.
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Affiliation(s)
- I-Fei Huang
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
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Abstract
OBJECTIVE Pyloric stenosis (PS) is rare in the first 2 weeks of life, often leading to delays in diagnosis and treatment. We conducted a case control study to delineate the characteristics of patients with early PS (EPS). In addition, we tested the hypothesis that patients with EPS present with a smaller pylorus than older patients. METHODS A database of all patients presenting with PS to a children's hospital over a 5-year period (2002-2006) was obtained. Each patient admitted during the first 2 weeks of life (subject) was matched to a patient admitted after 4 weeks of age (control), with the same gender, electrolyte status, and treating surgeon. A single pediatric radiologist, blinded to patient age, reviewed all available ultrasounds retrospectively. Demographic, clinical, diagnostic, therapeutic, and outcome data were compared. RESULTS During the study period, 278 pyloromyotomies were performed for PS. Sixteen patients (5.8%) presented with EPS between 2 and 14 days of life. EPS patients had a higher prevalence of positive family history (31 vs. 0%, P = 0.043), and breast milk feeding (75 vs. 31%, P = 0.045). Sonographic measurements showed a pylorus that was of significantly less length (17.1 +/- 0.6 vs. 20.5 +/- 0.9 mm, P = 0.006) and muscle thickness (3.5 +/- 0.2 vs. 4.9 +/- 0.2 mm, P < 0.001) in patients with EPS. Hospital stay was significantly longer for EPS patients (4.3 +/- 0.9 vs. 2.0 +/- 0.1 days, P = 0.19). CONCLUSIONS Babies presenting with EPS are more likely to be breast fed and to have a positive family history. EPS is associated with a longer hospital stay. Use of sonographic diagnostic measurements specific to this age group may prevent delays in diagnosis and treatment, and improve outcomes.
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Affiliation(s)
- Marie Demian
- Division of Pediatric Surgery, Miller Children’s Hospital, Long Beach, California & University of California, Irvine School of Medicine, Orange, CA USA
| | - Son Nguyen
- Department of Pediatric Radiology, Miller Children’s Hospital, Long Beach, CA USA
| | - Sherif Emil
- Division of Pediatric Surgery, Miller Children’s Hospital, Long Beach, California & University of California, Irvine School of Medicine, Orange, CA USA ,Division of Pediatric General Surgery, Montreal Children’s Hospital, 2300 Tupper, Room C-818, Montreal, QC H3H 1P3 Canada
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