[Vomiting in the different stages of childhood]

ABSTRACT

To determine the incidence, risk factors and diagnostic criteria of pyloric stenosis among infants suffering from refractory vomiting admitted in children's hospital of Damascus University. This study included every infant admitted in children's hospital complaining of any kind of vomiting between 2009 and 2010. Prospective descriptive study held on the study population, included illness history, physical examination, laboratory study, and imaging. Thirty two confirmed pyloric stenosis out of 460 cases admitted for vomiting were found in the study period [6.95%]. Male/female prevalence was 3/1. Six percent was premature infants. Positive family history found in 6.2% of cases. Infant of prime gravida contributed one third of all cases. Main mother age group was 21-25 year, no clear relation was noted with father's age group. On physical exam, pyloric olive palpation was positive in 40.6% [n=13], mild to moderate dehydration was present in 68.7% [n=22], failure to thrive in 78.12% [n=25] and accompanying congenital malformation noted in 6% [n=2] of cases. Diagnosis was made according to abdominal ultrasound done with a well experienced radiologist in 84% [n=27] of cases, while in 16% [n=5] of cases the diagnosis was made by upper gastrointestinal radio-opaque X-ray. The incidence of pyloric stenosis in this study is considered to be slightly higher than that found in international studies. Risk factors among pyloric stenosis cases were late admission, electrolyte disturbance, dehydration, failure to thrive and acid base imbalance. Ultrasound study is considered sensitive and specific way for pyloric stenosis diagnosis, and UGI opaque X-ray is good alternative