Infantile hypertrophic pyloric stenosis - Our experience and challenges in a developing country.

Autor: Ezomike UO; Sub-Department of Pediatric Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria., Ekenze SO; Sub-Department of Pediatric Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria., Amah CC; Sub-Department of Pediatric Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria., Nwankwo EP; Sub-Department of Pediatric Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria., Obianyo NE; Sub-Department of Pediatric Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria.
Jazyk: angličtina
Zdroj: African journal of paediatric surgery : AJPS [Afr J Paediatr Surg] 2018 Jan-Mar; Vol. 15 (1), pp. 26-30.
DOI: 10.4103/ajps.AJPS_51_16
Abstrakt: Background: This study aims to evaluate the experience and challenges in managing patients with infantile hypertrophic pyloric stenosis (IHPS).
Patients and Methods: From January 2007 to December 2015, data from patients with IHPS were retrospectively acquired and analyzed using SPSS version 15. Pearson correlation used to assess linear relationships and Student t-test to compare means. P < 0.05 was taken as statistically significant. Results were expressed as percentages, means ± standard deviation and illustrated in tables and graphs.
Results: Twenty-six cases were managed with the mean age at diagnosis of 49.16 ± 21.4 days. Mean birth weight was 3.7 kg and mean weight at presentation was 3.3 kg. Firstborn was affected in 29%; 91% were term deliveries; 9% were post-term; none was preterm; and 36% were exclusively breastfed. Mean duration of symptoms was 25.6 ± 18.9 days. Hyponatraemia was seen in 36%, hypokalaemia 37.5%, alkalosis 35% and hypochloraemia 62%. Mean pyloric tumour length was 22.85 ± 6.56 mm and pyloric wall thickness 5.51 ± 1.36 mm. There was a significant correlation between duration of symptoms and serum potassium level (R = -0.6326, P = 0.002). Mean symptom duration in patients with hypokalaemia was 39.88 ± 23.41 days and without hypokalaemia 17.15 ± 9.78 days (P = 0.006). Mean hospital stay was 9.45 ± 3.27 days. Four patients developed four complications and three patients died (11.5%). Mean age at presentation for pre-operative mortalities was 84 ± 39 days and 46 ± 17.98 days for others (P = 0.015).
Conclusions: IHPS presents late in our environment and occurs mainly in term males. There is a significant positive relationship between duration of symptoms and serum potassium level and the mean duration of symptoms was significantly longer in those with hypokalaemia. Pre-operative mortality was significantly associated with longer duration of symptoms.
Competing Interests: None
Databáze: MEDLINE
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