What is pediatric pyloric stenosis?

Updated: Nov 13, 2018
  • Author: Sathyaseelan Subramaniam, MD, FAAP; Chief Editor: Kirsten A Bechtel, MD  more...
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Answer

Pyloric stenosis, also known as infantile hypertrophic pyloric stenosis (IHPS), is the most common cause of intestinal obstruction in infancy. IHPS occurs secondary to hypertrophy and hyperplasia of the muscular layers of the pylorus, causing a functional gastric outlet obstruction.

In 1717, Blair first reported autopsy findings of pyloric stenosis. Although the description of the signs and symptoms of infantile hypertrophic pyloric stenosis can be found in the 17th century, the clinical picture and pathology were not accurately described until 1887 by the Danish pediatrician, Hirschsprung. Prior to 1912, early successful surgical procedures included gastroenterostomy, pyloroplasty, and forcible dilatation via gastrostomy. In 1912, Ramstedt observed an uneventful recovery in a patient following pyloroplasty, where sutures used in reapproximating the seromuscular layer had disrupted. Following this observation, he began leaving the split muscle layer unsutured in all subsequent repairs. The Ramstedt pyloromyotomy remains the standard procedure for pyloric stenosis today.

According to Pandya and Heiss, current recommendations include ultrasonography for diagnosis, preoperative corrections of electrolytes, and use of surgical techniques. [1]


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