Surgical Management of Infantile Hypertrophic Pyloric Stenosis in a District Hospital

Abstract

Background: Infantile hypertrophic pyloric stenosis is a common surgical condition with well-recognized clinical features. Diagnosis is usually straight forward and Ramstedt’s pyloromyotomy is curative. This study was conducted to see the output of surgery for infantile Hypertrophic pyloric stenosis by general surgeons at district hospital level.

Material & Methods: It was an experimental study conducted at surgical unit, DHQ Teaching Hospital, D.I.Khan from June 2003 to June 2008. Thirty four patients presenting to surgical ward with non-bilious projectile vomiting and a palpable pyloric tumour on examination, referring to the diagnosis of infantile hypertrophic pyloric stenosis were analyzed. The diagnosis was confirmed on ultrasonography. Patients with concomitant congenital anomalies were excluded.

Results: The mean age was 4 months with male to female ratio of 4.7:1. All the patients underwent pyloromyotomy. Regarding post-operative complications; 2.94% of patients had wound infection, 14.70% oral thrush and 20.58% had vomiting. All these complications responded well to conservative treatment.

Conclusion: The treatment of infantile hypertrophic pyloric stenosis may be performed in district hospitals with results comparable to those in specialized centers.