Surgical management of infantile hypertrophic pyloric stenosis - Can it beperformed by general surgeons?

Introduction: Debate exists as to whether IHPS can be treated in district g eneral hospitals as effectively as in specialist paediatric surgical units. Aim: To review the surgical treatment of IHPS in babies admitted to a distr ict general hospital under the care of two consultant general surgeons with a paediatric surgical interest. Patients and methods: The case notes of 66 babies operated on for IHPS over a 42 month period between April 1995 and September 1998 were retrospective ly reviewed. Demographics, operative details, hospital stay, and overall co mplications were all documented. Results: Peri-operative complications occurred in 2 patients, both requirin g omental patches for duodenal perforation. Nine patients had 1 or 2 episod es of postoperative vomiting; 4 had either a wound or urinary tract infecti on; and 1 baby developed an incisional hernia. There was no mortality. Discussion: The complication rate seen in this series is comparable to that of specialist centres, and supports current guidelines suggesting that IHP S can be managed by general surgeons with a paediatric surgical interest in a district general hospital.