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Infantile Hypertrophic pyloric stenosis: A retrospective study from a Tertiary Hospital in Ethiopia
Abstract
Back ground: Infantile hypertrophic pyloric stenosis(IHPS) is a common infantile disorder characterized by enlarged pyloric musculature and gastric outlet obstruction(1). IHPS typically presents with progressive projectile non-bilious vomiting this usually commences between second and eighth week of age. To date there is only one article written 23 years ago about IHPS in Ethiopia (9). The objectives of this study were to determine the incidence of IHPS at the Tikur Anbessa teaching referral hospital (TAH) over a period of 2 years, analyze the clinical presentations, mode of treatment and outcomes of treatment.
Methods: In this retrospective analysis, medical records of patients admitted to TAH, Addis Ababa, Ethiopia, with a diagnosis of IHPS in the years 2011 and 2012 were revised; information on age, sex, birth order, clinical presentation, treatment and outcomes of treatment were collected and analyzed.
Results: Sixty one infants with a diagnosis of IHPS were admitted to TAH, Addis Ababa, Ethiopia over a period of 2 years (2011-2012). The clinical records of 55 infants were retrieved and analyzed. The prevalence was 12.9/1000 admissions. The male to female ratio was 6.86:1. The mean age at admission was 44.47days. The mean duration of illness was 26.91 days. A palpable mass was found in 14(25.5%) of infants and constipation is reported in 14(25.5%). The treatment was Ramstedt’s pyloromyotomy in all cases. There were 6 (10.9%) intra-operative mucosal perforation. Eight patients developed postoperative complications - 6(10.9%) wound infections, and 2(3.8%) pneumonia. Two patients died.
Conclusions: This study has shown that IHPS is a common condition affecting infants with a prevalence of 12.9/1000 admissions. There was prolonged duration of illness, prolonged preoperative hospital stay and high proportion of dehydration and electrolyte disturbance. To avoid
delay in diagnosis physicians should have high index of suspicion in infants with non-bilious vomiting.
Methods: In this retrospective analysis, medical records of patients admitted to TAH, Addis Ababa, Ethiopia, with a diagnosis of IHPS in the years 2011 and 2012 were revised; information on age, sex, birth order, clinical presentation, treatment and outcomes of treatment were collected and analyzed.
Results: Sixty one infants with a diagnosis of IHPS were admitted to TAH, Addis Ababa, Ethiopia over a period of 2 years (2011-2012). The clinical records of 55 infants were retrieved and analyzed. The prevalence was 12.9/1000 admissions. The male to female ratio was 6.86:1. The mean age at admission was 44.47days. The mean duration of illness was 26.91 days. A palpable mass was found in 14(25.5%) of infants and constipation is reported in 14(25.5%). The treatment was Ramstedt’s pyloromyotomy in all cases. There were 6 (10.9%) intra-operative mucosal perforation. Eight patients developed postoperative complications - 6(10.9%) wound infections, and 2(3.8%) pneumonia. Two patients died.
Conclusions: This study has shown that IHPS is a common condition affecting infants with a prevalence of 12.9/1000 admissions. There was prolonged duration of illness, prolonged preoperative hospital stay and high proportion of dehydration and electrolyte disturbance. To avoid
delay in diagnosis physicians should have high index of suspicion in infants with non-bilious vomiting.
