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Congenital hypertrophic pyloric stenosis

  • Symposium on Common Pediatric Problems-II
  • Published:
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Abstract

Congenital hypertrophic pyloric stenosis, an important cause of intractable vomiting in infants is diagnosed clinically and confirmed ultrasonographically. Other useful interventions are plain radiography and berium study. Differential diagnosis includes pylorospasm and gastroesophageal reflux. Management protocol includes correction of dehydration and electrolyte imbalance and either Fredet Ramstedt pyloromyotomy or medical treatment with atropine sulphate. Atropine is initially given intravenously till vomiting is controlled and then orally at double the effective I.V. done for another 3 weeks. Atropine sulphate is generally well tolerated and side effects are few like tachycardia, raised SGPT and hyperthermia. Atropine sulphate is very effective, cheap, safe and perhaps more acceptable treatment option for CHPS.

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References

  1. Holt LE. Medical versus surgical treatment of pyloric stenosis in infancy.JAMA 1914; 62:2014.

    Google Scholar 

  2. Pollock WF, Norris WL, Gordon HE. The management of hypertrophic pyloric stenosis at the Los Angeles Children Hospital (a review of 1,422 cases).AM J Surg 1957; 94:335–349.

    Article  PubMed  CAS  Google Scholar 

  3. Rendle-Short J, Zachary RB. Congenital pyloric stenosis in older babies.Arch Dis Child 1955; 30:70–71.

    PubMed  CAS  Google Scholar 

  4. Blumhagen JB, Coombs JB. Ultrasound in the diagnosis of hypertrophic pyloric stenosis.J Clin Ultrasound 1981; 9: 289–292.

    Article  PubMed  CAS  Google Scholar 

  5. Blumhaven JB, Nobel HG. Muscle thickness in hypertrophic pyloric stenosis: sonographic determination.AJR 1983; 142 : 221–123.

    Google Scholar 

  6. Strauss S, Itzchack Y, Manor A, Heyman Z, Graif M. Sonography of hypertrophic pyloric stenosis.AJR 1981; 135: 1057–1058.

    Google Scholar 

  7. Struck E, Urbanek R. Sonography in the diagnosis of hypertrophic pyloric stenosis.Monatssch Kinderhilkd 1982; 130: 840–843.

    CAS  Google Scholar 

  8. Studen RJ, Lequesne GW, Little KET. The improved ultrasound diagnosis of hypertrophic pyloric stenosis.Pediatr Radiol 1986; 16:200–205.

    Article  Google Scholar 

  9. Singh UK, Kumar R, Singh S. Successful management of infantile hypertrophic pyloric stenosis with atropine sulphate. Indian Pediatr 2000/547 (accepted).

  10. Akira N, Jun Y, Kanji A, Atsushi Y, Takeshi Y, Makoto M. Management and ultrasonographic appearance of infantile hypertrophic pyloric stenosis with intrafenous atropine sulphate.J Pediatr Gastro Nutr 1996; 23:172–177.

    Article  Google Scholar 

  11. Kaxuko O, Yuko Y, Santoshi H, Motoko M, Sigetaka S, Makiko O. Oral treatment of atropine sulphate for infantile hypertrophic pyloric stenosis.J Jap Ped Soc 2001; 105:22–28.

    Google Scholar 

  12. Ganong WF. Regulation of gastrointestinal function; Review of Medical Physiology, 18th edn USA: Appleton and lange, 1997 : 448–479.

  13. Castro A, Mearin F, Gilvernet JM, MalagelActa JR. Infantile hypertrophic pyloric stenosis and achalasia: NO — related or non — related conditions.Digestion 1997; 58:596–598.

    PubMed  CAS  Google Scholar 

  14. Kanto J, Klotz U. Pharmacokinetic implications for the clinical use of atropine, scopolamine and glycopyrrolate.Acta Anaesthesiol Scand 1988; 32:69–78.

    PubMed  CAS  Google Scholar 

  15. Zedian B, Wyatt J, Mackersie A, Brereton RJ. Recent results of treatment of infantile hypertrophic pyloric stenosis.Arch Dis Chtid 1988; 63:1060–1064.

    Article  Google Scholar 

  16. Erikren CA, Anders CJ. Audit of results of operations for infantile pyloric stenosis in a district general hospital.Arch Dis Child 1991; 66:130–133.

    Google Scholar 

  17. Zhang AL, Class DT, Dubois RS, Cartmill T. Infantile hypertrophic pyloric stenosis, a clinical review from a general hospital.J Pediatr Child Health 1993; 23:272–278.

    Google Scholar 

  18. Okorie NM, Dickson JAS, Carver RA, Steiner GM. What happens to the pylorus after pyloromyotomy?Arch Dis Child 1988; 63:1339–1341.

    PubMed  CAS  Google Scholar 

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Correspondence to Utpal Kant Singh.

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Singh, U.K., Kumar, R. Congenital hypertrophic pyloric stenosis. Indian J Pediatr 69, 713–715 (2002). https://doi.org/10.1007/BF02722710

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