Infantile hypertrophic pyloric stenosis

2. Congenital hypertrophic
pyloric stenosis (CHPS)
Misnomer

3. •Idiopathic
•Genetic & Environmental factors

4. Hypertrophy of the circular muscle of
the pylorus( dueodenem is normal)

5.  First born male child
 Males 4:1
 Onset at 2-8 weeks of age, commonly at
around one month of age

9.  Coffee ground vomitus due to associated
gastritis
 Starvation stools
 Dehydration & weight loss

10. Ultrasound abdomen
 to look for the thickened >3.5mm and
elongated>15mm pylorus(doughnut sign)
 Gold standard at present, but needs an
experienced sonologist

11. Elongated narrow pyloric channel

12.  Hypochloremic hypokalemic metabolic
alkalosis
 Dehydration, alkalosis & electrolytes to be
corrected prior to surgery – may take upto 24
hours
 Fluid - 5% dextrose in 0.45 normal saline
containing 20 to 40 mEq/L of potassium

14.  Feeds can be started as soon as 6 hours post
operatively
 No long term complications
 ( 2 cm transverse incison after identifyin
prepylric vein. wound infetion wound dehisene
h’ge duod perforation (s urg complications)