INFANTILE HYPERTROPHIC PYLORIC-STENOSIS - A CLINICAL REVIEW FROM A GENERAL-HOSPITAL

A review of 212 cases of infantile hypertrophic pyloric stenosis (IHPS ) in a general hospital during an 8.5 year period documents clinical f eatures and suggests refinement of treatment Features such as sex, age at onset and presentation were similar to other studies. There was a preponderance of infants born in the summer. Premature infants represe nted 10% of the series, and the most premature (<33 weeks gestation) p resented later after birth (40 vs 25 days). Diagnosis was clinical in 65% of cases, but 4% presented before physical examination and diagnos tic tests were positive. At the time of admission only 15% had signifi cant abnormalities of serum electrolytes (chloride <85 mmol/L). The pe riumbilical incision resulted in a hidden scar. Duodenal perforation ( 3.3%) and wound dehiscence (1.4%) are related to technical factors and can be avoided. The timing of commencement of postoperative feeds did not influence the rate of vomiting. The average length of stay was 3. 5 days. These results are discussed with suggestions about how to mini mize diagnostic tests and length of hospital stay.