Infantile hypertrophic pyloric stenosis

Infantile hypertrophic pyloric stenosis

2. Congenital hypertrophic
pyloric stenosis (CHPS)
Misnomer

3. •Idiopathic
•Genetic & Environmental factors

4. Hypertrophy of the circular muscle of
the pylorus( dueodenem is normal)

5. First born male child
Males 4:1
Onset at 2-8 weeks of age, commonly at
around one month of age

9. Coffee ground vomitus due to associated
gastritis
Starvation stools
Dehydration & weight loss

10. Ultrasound abdomen
 to look for the thickened >3.5mm and
elongated>15mm pylorus(doughnut sign)
Gold standard at present, but needs an
experienced sonologist

11. Elongated narrow pyloric channel

12. Hypochloremic hypokalemic metabolic
alkalosis
Dehydration, alkalosis & electrolytes to be
corrected prior to surgery – may take upto 24
hours
Fluid - 5% dextrose in 0.45 normal saline
containing 20 to 40 mEq/L of potassium

14. Feeds can be started as soon as 6 hours post
operatively
No long term complications
( 2 cm transverse incison after identifyin
prepylric vein. wound infetion wound dehisene
h’ge duod perforation (s urg complications)