Correlation between pyloric muscle thickness and changes of acid-base status in children with congenital hypertrophic pyloric stenosis

Abstract

Introduction: Hypertrophic stenosis of the pylorus is one of the most common surgical conditions in children, which is commonly detected within the first 12 weeks of life. There is no known aetiology, but it is assumed that genetic factors and the environment are key elements, along with hypergastrinaemia and hyperacidity of the stomach. It is more common in male infants with a 4-6:1 ratio. Hypertrophy and hyperplasia of the muscular layer of the pylorus cause luminal obstruction resulting in characteristic explosive vomiting without admixture of bile. The gold standard for diagnosis is ultrasound. Therapy is surgical, but before surgery it is necessary to compensate fluid and electrolyte imbalance to prevent perioperative complications. Objective: The purpose of this paper is to show the correlation between changes of acid-base status and ultrasound muscle thickness in newborns with congenital hypertrophic stenosis of pylorus and the correlation between the duration of symptoms and the severity of metabolic disorders. Methods: In this retrospective study, we analysed medical history of 41 children hospitalized for suspected stenosis of the pylorus. Data were processed using descriptive statistics methods in TIBCO Statistics 13.4. Results: There was no statistically significant correlation between ultrasound muscle thickness and alkalosis level. The duration of symptoms and changes in pH value were not linearly related, but in two children with higher alkaline levels there was a higher degree of hypochloremia, and both patients had complications after surgical treatment. Conclusion: Although hypertrophic pyloric stenosis is a condition that can lead to severe metabolic disorders, they are rarely present owing to early diagnosis, effective electrolyte correction and quality health care. Key words: pylorus stenosis; INFANT