Abstract
Infantile hypertrophic pyloric stenosis (IHPS) is a common surgical condition encountered in early infancy. Despite the extensive research, the etiology of IHPS remains still obscure. Genetic, environmental, and hormonal factors have been implicated in the pathogenesis of this condition. In terms of the pathophysiology, abnormalities of smooth muscle cells, growth factors, extracellular matrix, nerve and supporting systems, neurotransmitter, and intestinal cell of Cajal have been also reported. The incidence is approximately 1–5:1,000 with a peak incidence of 2–8 weeks. Also, epidemiologically, wide variations of incidence have been reported with geographic location, season, and ethnic origin. Although extramucosal pyloromyotomy is the procedure of choice, the best way to approach the pylorus is debated; conventional right upper quadrant open procedure, transumbilical approach, and more recently laparoscopic procedure. This chapter outlines the new insights into the etiology and pathogenesis and also the important elements necessary to care for the patients in safe and effective manner.
References
Adibe OO, Nichol PF, Lim FY, et al. Ad libitum feeds after laparoscopic pyloromyotomy: a retrospective comparison with standardized feeding regimen in 227 infants. J Laparoendosc Adv Surg Tech A. 2007;17(2):235–7.
Alain JL, Grousseau D, Terrier G. Extramucosal pyloromyotomy by laparoscopy. Surg Endosc. 1991;5(4):174–5.
Aspelund G, Langer JC. Current management of hypertrophic pyloric stenosis. Semin Pediatr Surg. 2007;16(1):27–33.
Capon F, Reece A, Ravindarajah R, et al. Linkage of monogenic infantile hypertrophic pyloric stenosis to chromosome 16p12-p13 and evidence of genetic heterogeneity. Am J Hum Genet. 2006;79(2):378–82.
Cooper WO, Ray WA. Prenatal prescription of macrolide antibiotics and infantile hypertrophied pyloric stenosis. Obstet Gynecol. 2002;100(1):101–6.
Everett K, Chioza BA, Georgoula C, et al. Linkage of monogenic infantile hypertrophic pyloric stenosis to chromosome 16p24. Eur J Hum Genet. 2008a;16(9):1151–4.
Everett KV, Chioza BA, Georgroula C, et al. Genome-wide high-density SNP-based linkage analysis of infantile hypertrophic pyloric stenosis identifies loci on chromosomes 11q14-q22 and Xq23. Am J Hum Genet. 2008b;82(3):756–62.
Garza JJ, Morash D, Dzakovic A, et al. Ad libitum feeding decreases hospital stay for neonates after pyloromyotomy. J Pediatr Surg. 2002;37(3):493–5.
Georgeson KE, Corbin TJ, Griffen JW, et al. An analysis of feeding regimens after pyloromyotomy for hypertrophic pyloric stenosis. J Pediatr Surg. 1993;28(11):1478–80.
Hall NJ, Van Der Zee J, Tan HL, et al. Meta-analysis of laparoscopic versus open pyloromyotomy. Ann Surg. 2004;240(5):774–8.
Hernaz-Schulman M. Pyloric stenosis: role of imaging. Pediatr Radiol. 2009;39(Suppl 2):S134–9.
Huang PL, Dawson TM, Bredt DS, et al. Targeted disruption of neuronal nitric oxide gene. Cell. 1993;75:1273–86.
Indiran V, Selvaraj V. The cervix sign and other sonographic signs of hypertrophic pyloric stenosis. Abdom Radiol (NY). 2016;41(10):2085–6.
Iqbal CW, Rivard DC, Mortellao VE, et al. Evaluation of ultrasonographic parameters in the diagnosis of pyloric stenosis relative to patient age and size. J Pediatr Surg. 2012;47(8):1542–7.
Katz MS, Schwartz MZ, Moront ML, et al. Prophylactic antibiotics do not decrease the incidence of wound infections after laparoscopic pyloromyotomy. J Pediatr Surg. 2011;46(6):1086–8.
Kawai M, Peretta S, Burckhardt O, et al. Endoscopic pyloromyotomy: a new concept of minimally invasive surgery for pyloric stenosis. Endoscopy. 2012;44:169–73.
Kim SS, Lau ST, Lee SL, et al. Pyloromyotomy: a comparison of laparoscopic, circumumbilical and right upper quadrant operative techniques. J Am Coll Surg. 2005;201(1):66–70.
Koike Y, Uchihara K, Nakazawa M, et al. Predictive factors of negative outcome in initial atropine therapy for infantile pyloric stenosis. Pediatr Int. 2013;55(5):619–23. doi:10.1111/ped.12137.
Krogh C, Fischer TK, Skotte L, et al. Familial aggregation and heritability of pyloric stenosis. JAMA. 2011;303(23):2393–9.
Krohg C, Biggar RJ, Fischer TK, et al. Bottle-feeding and the risk of pyloric stenosis. Pediatrics. 2012;130:e943–9.
Kusafuka T, Puri P. Altered messenger RNA expression of neuronal nitric oxide synthase gene in infantile hypertrophic pyloric stenosis. Pediatr Surg Int. 1997;12:576–9.
Ladd AP, Nemeth SA, Grosfeld JL, et al. Supraumbilical pyloromyotomy: a unique indication for antimicrobial prophylaxis. J Pediatr Surg. 2005;40(6):974–7.
Laffoklie J, Turial S, Heckmann M, et al. Decline in infantile hypertrophic pyloric stenosis in Germany in 2000–2008. Pediatrics. 2012;129(4):e901–6.
Leaphart CL, Borland K, Kane TD, et al. Hypertrophic pyloric stenosis in newborns younger than 21 days: remodeling the path of surgical intervention. J Pediatr Surg. 2008;43(6):998–1001.
Leclair MD, Plattner V, Mirallie E, et al. Laparoscopic pyloromyotomy for hypertrophic pyloric stenosis: a perspective, randomized controlled trial. J Pediatr Surg. 2007;42(4):692–8.
Lowe LH, Banks WJ, Shyr Y, et al. Pyloric ratio: efficacy in the diagnosis of hypertrophic pyloric stenosis. J Ultrasound Med. 1999;18(11):773–7.
Macdessi J, Oates RK. Clinical diagnosis of pyloric stenosis: a declining art. BMJ. 1993;306(6877):553–5.
MacMahon B. The continuing enigma of pyloric stenosis of infancy: a review. Epidemiology. 2006;17(2):195–201.
Mahon BE, Rosenman MB, Kleiman MB. Maternal and infant use of erythromycin and other macrolide antibiotics as risk factors for infantile hypertrophic pyloric stenosis. J Pediatr. 2001;139(3):380–4.
Malcom 3rd GE, Raio CC, Del Rios M, et al. Feasibility of emergency physician diagnosis of hypertrophic pyloric stenosis using point-of-case ultrasound: a multi-center cases series. J Emerg Med. 2009;37(39):283–6.
Markel TA, Scott MR, Stokes SM, Ladd AP. A randomized trial to assess advancement of enteral feedings following surgery for hypertrophic pyloric stenosis. J Pediatr Surg. 2016. doi:10.1016/j.jpedsurg.2016.09.069. pii: S0022–3468(16)30457–2. [Epub ahead of print].
Murchison L, De Coppi P, Eaton S. Post-natal erythromycin exposure and risk of infantile hypertrophic pyloric stenosis: a systematic review and meta-analysis. Pediatr Surg Int. 2016;32(12):1147–52.
National Birth defect Prevention Network. Selected birth defects data from population based birth defects surveillance programs in United States, 2003–2007. Birth Defects Res A Clin Mol Teratol. 2010;88(12):1062–174.
NIedzielski J, Kobielski A, Sokal J, et al. Accuracy of sonographic criteria in the decision for surgical treatment in infantile hypertrophic pyloric stenosis. Arch Med Sci. 2011;7(3):508–11.
Nour S, Mackinnon AE, Dickson JA, et al. Antibiotics prophylaxis for infantile pyloromyotomy. J R Coll Surg Edinb. 1996;41(3):178–80.
Oomen MW, Hoekstra LT, Bakx R, et al. Open versus laparoscopic pyloromyotomy for hypertrophic pyloric stenosis: a systemic review and meta-analysis focusing on major complications. Surg Endosc. 2012;26(8):2104–10.
Panteli C. New insights into the pathogenesis of infantile pyloric stenosis. Pediatr Surg Int. 2009;25(12):1043–52.
Pedersen RN, Garne E, Loane M, EUROCAT Working Group, et al. Infantile hypertrophic pyloric stenosis: a comparative study of incidence and other epidemiological characteristics in seven European regions. J Matern Fetal Neonatal Med. 2008;21(9):599–604.
Persson S, Ekbom A, Granath F, et al. Parallel incidence of sudden infant death syndrome and infantile hypertrophic pyloric stenosis: a common cause? Pediatrics. 2001;108(4):E70.
Purapong D, Kahng D, Ko A, et al. Ad libitum feeding; safely improving the cost effectiveness of pyloromyotomy. J Pediatr Surg. 2002;37(12):1667–8.
Ranells JD, Carver JD, Kirby RS. Infantile hypertrophic pyloric stenosis: epidemiology, genetics and clinical update. Adv Pediatr Infect Dis. 2011;58(1):195–206.
Schari AF, Leditschke JF. Gastric motility after pyloromyotomy in infants: a reappraisal of postoperative feeding. Surgery. 1968;64(6):1133–7.
Serra A, Schuchardt K, Genuneit J, et al. The role of ret genomic variants in infantile hypertrophic pyloric stenosis. Eur J Pediatr Surg. 2011;21(6):389–94.
Shinohara K, Shimizu T. Correlation of prostaglandin E2 production and gastric acid secretion in infants with hypertrophic pyloric stenosis. J Pediatr Surg. 1998;33(10):1483–5.
Sola JE, Neville HL. Laparoscopic vs open pyloromyotomy: a systematic review and meta-analysis. J Pediatr Surg. 2009;44(8):1631–7.
Sorensen HT, Skriver MV. Risk of infantile hypertrophic pyloric stenosis after maternal postnatal use of macrolides. Scand J Infect Dis. 2003;35(2):104–6.
St Peter SD, Osstli DJ. Pyloric stenosis: from a retrospective analysis to a prospective clinical trial-the impact on surgical outcomes. Curr Opin Pediatr. 2008;20(3):311–4.
St Peter SD, Holcomb 3rd GW, Calkins CM, et al. Open versus laparoscopic pyloromyotomy for pyloric stenosis: a prospective, randomized trial. Ann Surg. 2006;244(3):363–7.
Sullivan KJ, Chan E, Vincent J, Canadian Association of Paediatric Surgeons Evidence-Based Resource, et al. Feeding post-pyloromyotomy: a meta-analysis. Pediatrics. 2016;137(1):1–11.
Svenningsson A, Soderhall C, Persson S, et al. Genome-wide linkage analysis in families with infantile hypertrophic pyloric stenosis indicates novel susceptibility loci. J Hum Genet. 2012;57(2):115–21.
Takeuchi M, Yasunaga H, Horiguchi H, et al. Pyloromyotomy versus i.v. atropine therapy for the treatment of infantile hypertrophic pyloric stenosis: nationwide hospital discharge database analysis. Pediatr Int. 2013;55(4):488–91.
Tan KC, Bianchi A. Circumumbilical incision for pyloromyotomy. Br J Surg. 1986;73(5):399.
Turnock RR, Rangercroft L. Comparison of pyloromyotomy feeding regimens in infantile hypertrophic pyloric stenosis. J R Coll Surg Edinb. 1991;36(3):164–5.
Wang J, Waller DK, Hwang LY, et al. Prevalence of infantile hypertrophic stenosis in Texas.1999–2002. Birth Defects Res A Clin Mol Teratol. 2008;82(11):763–7.
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Fujimoto, T. (2017). Infantile Hypertrophic Pyloric Stenosis. In: Puri, P. (eds) Pediatric Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38482-0_60-1
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DOI: https://doi.org/10.1007/978-3-642-38482-0_60-1
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