Infantile hypertrophic pyloric stenosis: profile, management and outcome of patients admitted to a tertiary hospital in Bloemfontein, South Africa

  • Robyn Arnold University of the Free State
  • Khotso Khokho University of the Free State
  • Kreasan Narrainsamy University of the Free State
  • Elizabeth Brits University of the Free State
  • Gina Joubert University of the Free State
Keywords: infantile hypertrophic pyloric stenosis, gender, birth order, symptoms

Abstract

Background: Infantile hypertrophic pyloric stenosis (IHPS) is the thickening of both muscle layers of the pylorus and is most commonly found in first-born males. It usually presents with projectile, non-bilious vomiting. Late presentation leads to severe dehydration and malnutrition with deranged serum-electrolytes and acid-base imbalance delaying treatment and prolonging hospital stay. This study aims to evaluate the profile, management and outcome of IHPS at a tertiary hospital in Bloemfontein, South Africa.

Methods: The study was a retrospective, descriptive record review including all patients with IHPS admitted to Universitas Hospital from January 2008 to February 2016. Of the 22 patients admitted, files for 19 patients were available for inclusion.

Results: Sixteen (84.2%) of the 19 patients were male. Of the 11 patients with available birth order, two were first-, two second-, six third- and one fourth-born. The patients’ ages ranged from 27 to 194 days (median 51 days). The most common symptoms were projectile vomiting (78.9%) and poor weight gain (68.4%). Six patients had no ultrasound done, and 17 patients underwent a Ramstedt-pyloromyotomy. Eight patients received atropine as part of their initial management. The duration of symptoms ranged from 1 to 58 days (median 14 days). There was no reported mortality. The length of stay ranged from 2 to 60 days (median 7 days).

Conclusion: The gender distribution and age at presentation were in keeping with the literature but not the birth order. The delay before surgery emphasises the poor general health and deranged biochemical state the patients present at the hospital.

Author Biographies

Robyn Arnold, University of the Free State

Undergraduate medical student, Department of Surgery, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa

Khotso Khokho, University of the Free State

Undergraduate medical student, Department of Surgery, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa

Kreasan Narrainsamy, University of the Free State

Undergraduate medical student, Department of Surgery, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa

Elizabeth Brits, University of the Free State

Department of Surgery, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa

Gina Joubert, University of the Free State

Department of Biostatistics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa

Published
2019-05-14
How to Cite
Arnold, R., Khokho, K., Narrainsamy, K., Brits, E., & Joubert, G. (2019). Infantile hypertrophic pyloric stenosis: profile, management and outcome of patients admitted to a tertiary hospital in Bloemfontein, South Africa. South African Journal of Surgery, 57(2), 64. Retrieved from http://sajs.redbricklibrary.com/index.php/sajs/article/view/2811
Section
Paediatric Surgery