Infantile hypertrophic pyloric stenosis at a tertiary care hospital in Tanzania: a surgical experience with 102 patients over a 5-year period

• Published in: BMC research notes 2015-11, Vol.8 (686), p.690-690, Article 690
• Main Authors: Chalya, Phillipo L, Manyama, Mange, Kayange, Neema M, Mabula, Joseph B, Massenga, Alicia
• Format: Article
• Language: English
• Subjects: Care and treatment; Dehydration (Physiology); Development and progression; Electrolytes; Female; Gastric Outlet Obstruction - diagnosis; Gastric Outlet Obstruction - etiology; Humans; Infant; Infant, Newborn; Length of Stay; Logistic Models; Male; Multivariate Analysis; Patient outcomes; Postoperative Complications; Pyloric stenosis; Pyloric Stenosis, Hypertrophic - complications; Pyloric Stenosis, Hypertrophic - diagnosis; Pyloric Stenosis, Hypertrophic - surgery; Retrospective Studies; Survival Analysis; Tanzania; Tertiary Healthcare; Treatment Outcome; Vomiting - diagnosis; Vomiting - etiology
• ISSN: 1756-0500; 1756-0500
• DOI: 10.1186/s13104-015-1660-4

Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of gastric outlet obstruction in infants. There is paucity of published data regarding this condition in our setting. This study describes the clinical presentation, mode of treatment and outcome of treatment of this disease and identifies factors responsible for poor outcome of these patients. This was a descriptive retrospective study of infants with HPS admitted to Bugando Medical Centre and subsequently underwent surgery between February 2009 and January 2014. A total of 102 patients (M:F = 4.7:1) were studied. The median age at presentation was 5 weeks. The median duration of illness was 4 weeks. Fifty-four (52.9 %) patients occur in first-born children. Associated anomalies were reported in 7 (6.9 %) patients. Non-bilious vomiting was the most frequent symptom and it was described in all (100 %) patients. A palpable mass was found in 23.5 % of infants. The diagnosis of IHPS was made clinically in 86 (84.3 %) and by ultrasound in 16 (15.7 %) patients. The treatment was Ramstedt's pyloromyotomy in all cases. There were 6 (5.9 %) intra-operative mucosal perforations which were repaired successively. Postoperative complication was 11.8 %. The median length of hospital stay was 12 days and it was significantly associated with prolonged pre-operative hospitalization (p = 0.001). The mortality rate was 4.9 %. Age below 2 weeks, late presentation (≥14 days), severe dehydration on admission, hypokalaemia on admission and surgical site infection were the main predictors of mortality (p < 0.001). This study has shown that IHPS is a common condition in our setting. Age