Infantile hypertrophic pyloric stenosis: a 4-year experience from two tertiary care centres in Cameroon

BMC Res Notes. 2018 Jan 16;11(1):33. doi: 10.1186/s13104-018-3131-1.

Abstract

Objective: This study aimed to describe the clinical characteristics of patients with infantile hypertrophic stenosis, management and its outcome in two tertiary care centres in Cameroon.

Results: A total of 21 patients were included from the two centres. The mean age at presentation was 5.2 ± 1.2 weeks, predominantly male with a male-to-female ratio of 4.25:1. The triad of vomiting, visible peristalsis and palpable mass was present in only 7 (33.3%) of the participants. The diagnosis was confirmed with ultrasounds in all participants. Ramstedt pyloromyotomy was done in all participants and in 9.5% of the participants it was complicated by intra-operative duodenal perforation whereas in the postoperative period the most common complications were vomiting (6, 28.6%), sepsis (2, 9.5%), and paralytic ileus (2, 9.5%). The mortality rate from the series is 9.5%. According to univariate logistic regression: severe dehydration [OR = 5.41, 95% CI = (3.11-6.97), p = 0.002], hypokalaemia [OR = 2.63, 95% CI = (1.02-5.91), p = 0.042] and surgical site infection [OR = 3.12, 95% CI (1.22-5.64), p = 0.023] were the main predictors of mortality whereas postoperative hospital length of stay > 5 days was significantly associated with surgical site infection [OR = 2.44, 95% CI = (1.12-6.44), p = 0.002] and postoperative nausea and vomiting [OR = 3.64, 95% CI = (1.18-6.64), p = 0.022].

Keywords: Experience; Infantile hypertrophic pyloric stenosis; Mortality; Outcome; Ramstedt.

Publication types

  • Multicenter Study

MeSH terms

  • Cameroon
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Length of Stay / statistics & numerical data
  • Logistic Models
  • Male
  • Nausea / etiology
  • Postoperative Complications / etiology
  • Pyloric Stenosis, Hypertrophic / diagnosis
  • Pyloric Stenosis, Hypertrophic / surgery*
  • Pyloromyotomy / adverse effects
  • Pyloromyotomy / methods*
  • Tertiary Care Centers*
  • Vomiting / etiology