Arnold R, Khokho K, Narrainsamy K, Brits E, Joubert G
Undergraduate medical student, Department of Surgery, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
Department of Surgery, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
S Afr J Surg. 2019 Jun;57(2):64.
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.
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.
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).
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.
婴儿肥厚性幽门狭窄（IHPS）是幽门肌层的增厚，最常见于头胎男性。通常表现为喷射性、非胆汁性呕吐。延迟就诊会导致严重脱水和营养不良，伴有血清电解质紊乱和酸碱失衡，从而延误治疗并延长住院时间。本研究旨在评估南非布隆方丹一家三级医院中婴儿肥厚性幽门狭窄的概况、治疗及结局。
本研究是一项回顾性描述性记录回顾，纳入了2008年1月至2016年2月入住尤尼韦塔斯医院的所有婴儿肥厚性幽门狭窄患者。在22例入院患者中，有19例患者的病历可供纳入研究。
19例患者中有16例（84.2%）为男性。在11例有出生顺序信息的患者中，2例为头胎，2例为二胎，6例为三胎，1例为四胎。患者年龄在27至194天之间（中位数为51天）。最常见的症状是喷射性呕吐（78.9%）和体重增加缓慢（68.4%）。6例患者未进行超声检查，17例患者接受了Ramstedt幽门肌切开术。8例患者在初始治疗中使用了阿托品。症状持续时间为1至58天（中位数为14天）。无死亡报告。住院时间为2至60天（中位数为7天）。
性别分布和就诊年龄与文献相符，但出生顺序不符。手术前的延迟凸显了患者入院时总体健康状况不佳和生化状态紊乱的情况。
