J Korean Surg Soc.  2010 Mar;78(3):184-191. 10.4174/jkss.2010.78.3.184.

The Clinical Features and Management of IHPS: A Comparison between 1980's and 2000's

• Woo JH
• Choi KJ

• KMID: 2211947
• DOI: http://doi.org/10.4174/jkss.2010.78.3.184

Abstract

PURPOSE
A precise and simple tool for diagnosis and the growing public interest in health caused infantile hypertrophic pyloric stenosis (IHPS) to be diagnosed in good time. The approach to pyloromyotomy as the standard treatment is undergoing changes. We compared 2000's IHPS patients with 1980's to identify the clinical features and management.
METHODS
We analyzed, retrospectively, the clinical findings, diagnoses, and treatment of 68 patients with IHPS who underwent pyloromyotomy at Ewha Womans University Medical Center from January 2000 to December 2008 (2000's group), and compared the results with that of 42 patients in the 1980's (1980's group).
RESULTS
There were no significant differences in age, gender, birth rank, seasonal distribution, and symptoms between both groups, but the number of patients with metabolic changes and palpable 'olive' was significantly lesser in the 2000's group. Upper gastrointestinal series (UGI) was the most common imaging tool in the 1980's (71.4%) but USG has become the standard diagnostic tool in the 2000's (88.2%). All patients received open pyloromyotomy using traditional incision in the 1980's, and supraumbilical semicircular incision in 36.8% of patients in the 2000's. The average length of hospital stay after operation was significantly shorter in the 2000's group. In the 2000's, the mean preoperative stay at hospital was 4.4+/-4.3 days. Twenty-nine (42.0%) patients did not vomit postoperatively and postoperative vomiting did not delay discharges of any patients.
CONCLUSION
There were significant improvements in diagnosis and treatment in the 2000's. We suggest that the surgeon, without the need for a radiologist perform USG for IHPS in order to shorten the preoperative hospital stay.

Keyword

IHPS; Clinical features; Diagnosis; Treatment

MeSH Terms

Academic Medical Centers
Female
Humans
Length of Stay
Parturition
Postoperative Nausea and Vomiting
Pyloric Stenosis, Hypertrophic
Retrospective Studies
Seasons

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