HYPERTROPHIC PYLORIC-STENOSIS IN INFANTS

From 1983 through 1993, 175 infants had surgery for hypertrophic pylor ic stenosis at the Department of Infantile Surgery, Strasbourg Teachin g Hospital, France. Boys represented 81% of this population. Mean age at onset of vomiting was 3.9 weeks. At admission, the weight curve was flat or had fallen off. Seven patients had another congenital abnorma lity (two cases of Type III esophageal atresia and one case each of re nal multicystic dysplasia, ureterohydronephrosis of the upper pole of the left kidney with ureterocele, spontaneous pneumothorax, left diaph ragmatic hemia, cystic fibrosis). Thirteen patients had a positive fam ily history for hypertrophic pyloric stenosis. All patients were treat ed by extramucous pyloromyotomy through a horizontal subcostal incisio n. The postoperative complication rate was only 3%. None of the patien ts died. Although extramucous pyloromyotomy yields excellent results, data from the recent literature have generated debate as to the value of nonsurgical treatment and as to the respective merits of various in cisions.