National Center for Biotechnology Information , U. Pediatric Surgery International. Pediatr Surg Int. Published online Aug Author information Article notes Copyright and License information Disclaimer. Sherif Emil, Phone: , Fax: , Email: ac. Corresponding author.
Accepted Aug 4. This article has been cited by other articles in PMC. Abstract Objective Pyloric stenosis PS is rare in the first 2 weeks of life, often leading to delays in diagnosis and treatment.
Results During the study period, pyloromyotomies were performed for PS. Conclusions Babies presenting with EPS are more likely to be breast fed and to have a positive family history. Introduction Infantile hypertrophic pyloric stenosis PS , first described by Hirschsprung [ 1 ], occurs in approximately 3 of every 1, livebirths [ 2 ], making it the most common indication for surgical intervention in infancy.
Table 1 Demographics. Open in a separate window. Table 2 Clinical characteristics. Table 3 Sonographic measurements. Table 4 Therapeutic and outcome data. Conclusions In this pilot study of patients presenting with pyloric stenosis during the first 2 weeks of life, we found an increase in genetic predisposition and breast milk feeding.
Open Access This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author s and source are credited.
References 1. Hirschsprung H. Falle von angeborener Pylorus Stenose. J Kinderheilk. The epidemiology of infantile hypertrophic pyloric stenosis. Paediatr Perinat Epidemiol. Hernanz-Schulman M. Infantile hypertrophic pyloric stenosis. Reliability of ultrasound for the diagnosis of hypertrophic pyloric stenosis. J Pediatr Gastroenterol Nutr. Hypertrophic pyloric stenosis: determination of muscle dimensions by ultrasound. Br J Radiol. Pyloric stenosis: congenital or acquired?
Arch Dis Child. Hypertrophic pyloric stenosis in the neonate—diagnostic criteria revisited. Can Assoc Radiol J. Hypertrophic pyloric stenosis in the infant without a palpable olive: accuracy of sonographic diagnosis.
Diagnosing hypertrophic pyloric stenosis: does size matter? Eur J Pediatr Surg. Ultrasound diagnosis of infantile hypertrophic pyloric stenosis: determinants of pyloric length and the effect of prematurity. Clin Radiol. Muscle thickness in infants hypertrophic pyloric stenosis. Pediatr Med Chir. Ultrasound Q. For example, pyloric stenosis is four times more common in males than females. Once a child has been born with pyloric stenosis, the chance for it to happen again depends on the gender of the child already born with the condition, as well as the gender of the next child.
In addition to a complete medical history and physical examination, diagnostic procedures for pyloric stenosis may include:. Abdominal X-rays.
A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
Abdominal ultrasound. A diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels. A diagnostic test that examines the organs of the upper part of the digestive system: the esophagus, stomach, and duodenum the first section of the small intestine.
A fluid called barium a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an X-ray is swallowed. X-rays are then taken to evaluate the digestive organs. Pyloric stenosis must be repaired with an operation. However, doctors may need to treat your baby's dehydration and mineral imbalances first. Water and minerals can be replaced through intravenous IV fluid. Once your baby is no longer dehydrated, surgery can be performed. Under anesthesia, a small incision is made above the navel and the tight pyloric muscle is repaired.
Babies can often begin drinking small amounts of clear liquids in the first 24 hours. Laparoscopic pyloromyotomy generally involves the use of two or three trocars, and therefore usually requires two or three small incisions. If the surgeon decides that a laparoscopic operation is not the best way to treat the problems that are found in the operating room, then the operation will be changed converted to use an older surgical technique.
In general, patients who receive surgical treatment for pyloric stenosis have an excellent recovery and very few suffer any long-term problems as a result of the disease. After surgery, your baby may be fed special fluids for one or two feedings and then breast milk or formula within 24 hours. The hospital stay following a pyloromyotomy is typically one or two days, and the decision to discharge a patient is based on how well the child is recovering: specifically, if the baby is able to drink breast milk or formula without vomiting and has pain that can be controlled by medications taken by mouth.
It is normal for a baby to vomit small amounts during the first day or two after surgery, but this should gradually improve. If your baby continues to vomit after you return home, call your doctor, because this may indicate continued blockage that is preventing the stomach from emptying normally.
Parents and other caregivers should refer first to written discharge instructions and use the telephone numbers provided to reach the pediatric surgery team to discuss any problems. These instructions are provided for specific patients after considering their medical conditions, the operation performed and how well the patient is recovering.
Therefore, the instructions received at the time of discharge or afterward over the phone or in the Pediatric Surgery Clinic are the best resource for parents and caregivers if questions arise.
In general, the following findings should cause concern and require a patient to be seen by a doctor:. Spreading redness, drainage leaking fluid from the surgical wounds that looks like pus. Increased bloody drainage from wound. Show references Kliegman RM, et al. Pyloric stenosis and other congenital anomalies of the stomach. In: Nelson Textbook of Pediatrics. Elsevier; Accessed Oct. Olive AP, et al. Infantile hypertrophic pyloric stenosis.
Jobson M, et al. Contemporary management of pyloric stenosis. Seminars in Pediatric Surgery.
0コメント