Hypertrophic pyloric stenosis
Hypertrophic Pyloric Stenosis
Hypertrophic pyloric stenosis (HPS) is a condition that affects infants, typically presenting within the first few weeks of life. It is characterized by the hypertrophy of the pyloric muscle, which leads to gastric outlet obstruction. This condition is a common cause of projectile vomiting in infants and requires surgical intervention.
Pathophysiology[edit | edit source]
The pylorus is the region of the stomach that connects to the duodenum. In hypertrophic pyloric stenosis, the circular muscle fibers of the pylorus become abnormally enlarged, leading to narrowing of the pyloric channel. This hypertrophy results in obstruction of gastric emptying, causing the stomach contents to be forcefully expelled.
Epidemiology[edit | edit source]
Hypertrophic pyloric stenosis occurs in approximately 2 to 4 per 1,000 live births. It is more common in males than females, with a male-to-female ratio of about 4:1. The condition is also more prevalent in first-born children and has a higher incidence in Caucasian populations.
Clinical Presentation[edit | edit source]
Infants with hypertrophic pyloric stenosis typically present with:
- Projectile, non-bilious vomiting that occurs shortly after feeding.
- Persistent hunger and irritability due to inadequate feeding.
- Dehydration and weight loss as the condition progresses.
- A palpable "olive-like" mass in the right upper quadrant of the abdomen, which is the hypertrophied pylorus.
Diagnosis[edit | edit source]
The diagnosis of hypertrophic pyloric stenosis is primarily clinical, supported by imaging studies.
- Ultrasound is the preferred diagnostic tool, revealing a thickened pyloric muscle and elongated pyloric channel.
- Barium swallow may show the "string sign," indicating a narrowed pyloric channel.
Treatment[edit | edit source]
The definitive treatment for hypertrophic pyloric stenosis is surgical intervention, specifically a procedure called pyloromyotomy. This involves splitting the muscle of the pylorus to relieve the obstruction. The procedure is typically performed laparoscopically and has a high success rate with minimal complications.
Prognosis[edit | edit source]
With timely surgical intervention, the prognosis for infants with hypertrophic pyloric stenosis is excellent. Most infants recover quickly and can resume normal feeding within a few days post-surgery.
Also see[edit | edit source]
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