RESUMEN
PURPOSE: This study was done to analyze the changes in the clinical conditions and the diagnosis of hypertrophic pyloric stenosis. METHODS: We report a retrospective clinical analysis of 39 patients with hypertrophic pyloric stenosis from Jan. 1992 to Aug. 2001. The age and sex distribution, family and birth history, clinical symptoms, the ultrasonographic and the operative sizes of pyloric canals were compared. RESULTS: The body weight was below the 3 percentile at admission in eight cases(20.5%). "Olive like mass" in right upper quadrant was palpated during physical examination in 23 cases(59%) and gastric peristaltic wave observed in six cases(15%). The ultrasonographic measurements showed that the pyloric muscle thickness to be 4.95+/-0.99 mm(mean+/-SD), pyloric diameter 14.42+/-2.64 mm, and pyloric length 20.17+/-3.92 mm. Fredet-Ramstedt pyloromyotomy was employed in all cases. The operative measurements of the pyloric muscle thickness was 5.11+/-1.01 mm, pyloric diameter 15.01+/-2.47 mm, and pyloric length 22.32+/-3.43 mm. CONCLUSION: There was no significant difference between the ultrasonographic and operative measurements. Currently, the hypertrophic pyloric stenosis patients showed lesser clinical hallmarks of the disease. The earlier diagnosis using imaging studies before development of significant metabolic abnormalities is becoming an important factor that change the future outcomes of hypertrophic pyloric stenosis.