Infantile Hypertrophic Pyloric Stenosis (IHPS) have also known only as pyloric stenosis. This disease have reported in 1 of 1000 births and the cause is unknown currently. Pyloric stenosis is approximately four times more common in males also. It have also characterized by hypertrophy and stenosis of muscular valve which have based on the region between stomach and twelve finger intestine that called pylorus, as understood from the name. The smooth muscles in the pyloric area become thicker than normal and as a result the transition between the stomach and the duodenum (duodenum) may diminished and sometimes becomes impossible. For this reason, the food inside the stomach can not reach to the duodenum and the small intestines and the eaten foods will accumulate in the stomach.
After a certain period of time vomiting will occur. The infant will vomit out all the food that he had taken.
In %76 of the patients with hypertrophic pyloric, may find with touching on physical examination a tuber in right upper abdomen like olive kernel. In ultrasound pyloric muscular wall thickness will measured more than 3 mm. Patients have vomiting and dehydration according to the degree of stenosis. The infants may lose weight and even they can not maintain their birth weight also. Although, diagnosis and treatment are simple, even physiological vomiting is seen in all infants and patients die because of dehydration and malnutrition.
Usually the symptoms will start 3-6. weeks after birth.Then the general condition of the patient begins to deteriorate. The infant will have good appetite, but also he will lose weight. Patients may less likely to have stool release and constipation is obvious. Vomiting occurs approximately 1 / 2-1 hours after the meal. At the beginning, vomiting starts in reflux style but becomes increasingly violent. Then it become to a gushing style. No bile may seen in the vomiting material, because the pylory have clogged.
The diagnosis of Infantile Hypertrophic Pyloric Stenosis may done by physical examination and ultrasound can performed for confirmation. In ultrasonography the pylorus will seen as a thickened muscle tissue.
The treatment is surgical, and extramucosal pyloromyotomy surgery may still performed as Dr. Ramstedt described. Before surgery, the patient must be hydrated well and the electrolyte imbalance should be corrected. These patients will have usually severe dehydration and hypochloremic metabolic alkalosis at the time of admission. The patient must operated during the newborn period, so resistance to both operation and infections will be low also. For these reason, the postoperative care should performed well. Post-operative wound site should checked daily. If an infection develops, it should treated immediately. With it the patient should be followed in the hospital environment up to 5-7 days after surgery. Before planning discharge, the patient must have well generally condition and regular stool release. Regularly feeding must performed after discharge also.