Pediatric Surgery International

, Volume 23, Issue 1, pp 61–63 | Cite as

Infantile hypertrophic pyloric stenosis: an infectious cause?

Original Article

Abstract

The aetiology of infantile hypertrophic pyloric stenosis (IHPS) remains unclear. The aim of this study was to test the hypothesis that a common bacterium, Helicobacter pylori (HP) may be implicated in the pathogenesis of IHPS. Thirty-nine consecutive infants with confirmed IHPS had their stool analysed with an enzyme immunoassay for the presence of HP. An age/sex-matched group of infants with unrelated surgical conditions were also tested. No positive results for the presence of HP stool antigen were obtained in the study nor the control group. The results of this study demonstrate no causative link between HP and IHPS. A genetic basis has been implicated for IHPS. However, evidence does exist that IHPS is a condition acquired after birth and that an infective agent may be involved in the pathogenesis. Further studies are required to elucidate perinatal factors that may induce the expression of this condition in a genetically sensitive individual.

Keywords

Pyloric stenosis Helicobacter pylori 

References

  1. 1.
    Ohshiro K, Puri P (1998) Pathogenesis of infantile hypertrophic pyloric stenosis: recent progress. Pediatr Surg Int 13:243–252PubMedCrossRefGoogle Scholar
  2. 2.
    Abel RM, Bishop AE, Dore CJ, et al (1998) A quantitative study of the morphological and histochemical changes within the nerves and muscle in infantile hypertrophic pyloric stenosis. J Pediatr Surg 33(5):682–687PubMedCrossRefGoogle Scholar
  3. 3.
    Paulozzi LJ (2000) Is Helicobacter pylori a cause of infantile hypertrophic pyloric stenosis? Med Hypotheses 55(2):119–125PubMedCrossRefGoogle Scholar
  4. 4.
    Rowland M, Drumm B (1998) Clinical significance of Helicobacter infection in children. Br Med Bull 54(1):95–103PubMedGoogle Scholar
  5. 5.
    Blecker U, Lanciers S, Hauser B, et al (1994) The prevalence of Helicobacter pylori positivity in a symptom-free population, aged 1 to 40 years. J Clin Epidemiol 47(10):1095–1098PubMedCrossRefGoogle Scholar
  6. 6.
    Ganstrom M, Tindberg Y, Blennow M (1997) Seroepidemiology of Helicobacter pylori infection in a cohort of children monitored from 6 months to 11 years of age. J Clin Microbiol 35(2):468–470Google Scholar
  7. 7.
    Ashorn M, Miettinen A, Ruuska T, et al (1996) Seroepidemiological study of Helicobacter pylori infection in infancy. Arch Dis Child Fetal Neonatal Ed 74(2):F141–142PubMedGoogle Scholar
  8. 8.
    Gold BD, Khanna B, Huang LM, et al (1997) Helicobacter pylori acquisition in infancy after decline of maternal passive immunity. Pediatr Res 41:641–646PubMedGoogle Scholar
  9. 9.
    Chang MC, Wu MS, Wang HH, et al (1999) Helicobacter pylori stool antigen (HpSA) test—a simple, accurate and non-invasive test for detection of Helicobacter pylori infection. Hepatogastroenterology 46(25):299–302PubMedGoogle Scholar
  10. 10.
    Altindis M, Dilek ON (2002) Usefulness of the Helicobacter pylori stool antigen test for detection of Helicobacter pylori infection. Acta Gastroenterol Belg 65(2):74–76PubMedGoogle Scholar
  11. 11.
    van Doorn OJ, Bosman DK, van’t Hoff BW, et al (2001) Helicobacter pylori stool antigen test: a reliable non-invasive test for the diagnosis of Helicobacter pylori infection in children. Eur J Gastroenterol Hepatol 13(9):1061–1065PubMedCrossRefGoogle Scholar
  12. 12.
    Konstantopoulos N, Russman H, Tasch C, et al (2001) Evaluation of the Helicobacter pylori stool antigen test (HpSA) for detection of Helicobacter pylori infection in children. Am J Gastroenterol 96(3):677–683PubMedCrossRefGoogle Scholar
  13. 13.
    Koletzko S, Konstantopoulos N, Bosman D, et al (2003) Evaluation of a novel monoclonal enzyme immunoassay for detection of Helicobacter pylori antigen in stool from children. Gut 52(6):804–806PubMedCrossRefGoogle Scholar
  14. 14.
    Rollins MD, Shields MD, Quinn RJM, et al (1989) Pyloric stenosis: congenital or acquired? Arch Dis Child 64:138–147PubMedCrossRefGoogle Scholar
  15. 15.
    Bidair M, Kalota SJ, Kaplan GW (1993) Infantile hypertrophic pyloric stenosis and hydronephrosis: is there an association? J Urol 150(1):153–155PubMedGoogle Scholar
  16. 16.
    Mitchell LE, Risch N (1993) The genetics of infantile hypertrophic pyloric stenosis: a reanalysis. Am J Dis Child 147(11):1203–1211PubMedGoogle Scholar
  17. 17.
    Ceccarelli M, Villirillo A, Assanta N, et al (1992) Hypertrophic pyloric stenosis in infants. A retrospective study of cases observed in the years 1970–1990. Pediatr Med Chir 14(4):441–443PubMedGoogle Scholar
  18. 18.
    Sorenson HT, Skriver MV, Pederson L, et al (2003) Risk of infantile hypertrophic pyloric stenosis after maternal postnatal use of macrolides. Scand J Infect Dis 35(2):104–106CrossRefGoogle Scholar
  19. 19.
    Cooper WO, Ray WA, Griffin MR (2002) Prenatal prescription of macrolide antibiotics and infantile hypertrophic pyloric stenosis. Obstet Gynecol 100(1):101–106PubMedCrossRefGoogle Scholar
  20. 20.
    Langer JC, Berezin I, Daniel EE (1995) Hypertrophic pyloric stenosis: ultrastructural abnormalities of enteric nerves and the interstitial cells of Cajal. J Pediatr Surg 30(11):1535–1543PubMedCrossRefGoogle Scholar
  21. 21.
    Green MS (1992) The male predominance in the incidence of infectious diseases in children: a postulated explanation for disparities in the literature. Int J Epidemiol 21:381–386PubMedGoogle Scholar
  22. 22.
    Agunod M, Yamaguchi N, Lopez R, et al (1969) Correlative study of hydrochloric acid, pepsin and intrinsic factor secretion in newborns and infants. Am J Dig Dis 14:400–413PubMedCrossRefGoogle Scholar
  23. 23.
    Dinsmore JE, Jackson RJ, Smith SD (1997) The protective role of gastric acidity in neonatal bacterial translocation. J Pediatr Surg 32(7):1014–1016PubMedCrossRefGoogle Scholar
  24. 24.
    Roma-Giannikou E, Karameris A, Balatsos B, et al (2003) Intrafamilial spread of Helicobacter pylori: a genetic analysis. Helicobacter 8(1):15–20PubMedCrossRefGoogle Scholar
  25. 25.
    Spicer RD (1982) Infantile hypertrophic pyloric stenosis: a review. Br J Surg 69:128–135PubMedGoogle Scholar
  26. 26.
    Perri F, Pastore M, Clemente R, et al (1998) Helicobacter pylori infection may undergo spontaneous eradication in children: a 2-year follow-up study. J Pediatr Gastroenterol Nutr 27(2):181–183PubMedCrossRefGoogle Scholar
  27. 27.
    Dahshan A, Donovan KG, Halabi IM, et al (2006) Helicobacter pylori and infantile hypertrophic pyloric stenosis: is there a possible relationship? J Pediatr Gastroenterol Nutr 42:262–264PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  1. 1.Department of Paediatric SurgeryUniversity of Oxford, John Radcliffe HospitalOxfordUK

Personalised recommendations