CLINICAL, DIAGNOSTIC, AND SURGICAL ASPECTS OF HYPERTROPHIC PYLORIC STENOSIS

Abstract

Hypertrophic pyloric stenosis is a relatively common condition in the neonatal age group, characterized by progressive hypertrophy of the pyloric muscle layer, leading to gastric outlet obstruction. It predominantly affects male infants between the second and eighth weeks of life, with a typical clinical presentation of postprandial, non-bilious projectile vomiting, weight loss, and signs of dehydration. The etiology remains uncertain, but studies suggest a multifactorial basis involving genetic predisposition, hormonal influences, and environmental factors such as early macrolide antibiotic exposure. Diagnosis is primarily clinical and confirmed by imaging, especially abdominal ultrasonography, which reveals a pyloric muscle thickness greater than 3 mm and elongation of the pyloric canal. The standard treatment is Ramstedt’s extramucosal pyloromyotomy, preferably performed laparoscopically, offering excellent recovery and low complication rates. Prognosis is very favorable with early diagnosis and timely surgical management. Despite its classic presentation, hypertrophic pyloric stenosis requires careful clinical assessment to avoid delayed diagnosis and associated complications. Early recognition and proper treatment result in high cure rates and minimal morbidity and mortality.