The clinical features and management of IHPS: A comparison between 1980's and 2000's

Abstract

Purpose: A precise and simple tool for diagnosis and the growing public interest in health caused infantile hypertrophic pyloric stenosis (IHPS) to be diagnosed in good time. The approach to pyloromyotomy as the standard treatment is undergoing changes. We compared 2000's IHPS patients with 1980's to identify the clinical features and management. Methods: We analyzed, retrospectively, the clinical findings, diagnoses, and treatment of 68 patients with IHPS who underwent pyloromyotomy at Ewha Womans University Medical Centerfrom January 2000 to December 2008 (2000's group), and compared the results with that of 42 patients in the 1980's (1980's group). Results: There were no significant differences in age, gender, birth rank, seasonal distribution, and symptoms between both groups, but the number of patients with metabolic changes and palpable 'olive' was significantly lesser in the 2000's group. Upper gastrointestinal series (UGI) was the most common imaging tool in the 1980's (71.4%) but USG has become the standard diagnostic tool in the 2000's (88.2%). All patients received open pyloromyotomy using traditional incision in the 1980's, and supraumbilical semicircular incision in 36.8% of patients in the 2000's. The average length of hospital stay after operation was significantly shorter in the 2000's group.In the 2000's, the mean preoperative stay at hospital was 4.4±4.3 days. Twenty-nine(42.0%) patients did not vomit postoperatively and postoperative vomiting did not delay discharges of any patients. Conclusion: There were significant improvements in diagnosis and treatment in the 2000's. We suggest that the surgeon, without the need for a radiologist perform USG for IHPS in order to shorten the preoperative hospital stay.