Piloromiotomía laparoscópica: tratamiento de estenosis hipertrófica del píloro / Laparoscopic pyloromyotomy treatment of hipertrophic pyloric stenosis

Introducción: la estenosis hipertrófica del píloro es una condición común de la infancia. El tratamiento convencional consiste en realizar una piloromiotomía a través de una incisión en el cuadrante superior derecho del abdomen. El desarrollo de la cirugía videolaparoscópica nos ha permitido realizar este procedimiento, ofreciendo los mismos resultados que la técnica tradicional. Material y métodos: en la Sección de Cirugía Pediátrica del Hospital Roosevelt se han realizado 10 piloromiotomías videolaparoscópicas en los últimos tres meses. El procedimietno se realiza a través de tres puertos de cinco milímetros, localizados en el ombligo...

Clinical and laboratory features of hypertrophic pyloric stenosis

Hypertrophic Pyloric stenosis [HPS] is the most common surgical condition of stomach and duodenum which presents with intractable vomiting during the first weeks of life and death is unavoidable if left without treatment. This study aimed at evaluating the clinical and paraclinical characteristics of the disease in order to emphasize the importance of this potentially life threatening disease. In this retrospective study, from 1358 to 1382 hospital records of all the infants admitted in Shiraz university hospitals with the diagnosis of HPS were studied. From the 231 infants studied, 202 [87%] were male and 29 [13%] were female [male to female ratio of 8 to 1]. Ten cases [4.3%] had positive family history of the disease. 35 [15%] of them were the first child of the family. The onset of symptoms was between 2[nd] and 5[th] weeks of life in majority of the cases [75%]. Olive mass was observed in 116 [51%] of the cases, while constipation, bloody vomiting and jaundice were documented in 36%, 2% and 9% of the cases, respectively. Upper gastrointestinal series was diagnostic in 86% of the cases. However, abdominal sonography was helpful in only 88% of the cases. With proper observation and early diagnosis [by means of abdominal sonography] of patients suffering from repeated episodes of vomiting, the mortality and morbidity of this disease can be reduced