Hypoglycemia with hepatic glycogen depletion: A postoperative complication of pyloric stenosis

Abstract

Three infants with congenital hypertrophic pyloric stenosis developed hypoglycemia, convulsions and cardiac arrest in the postoperative period coincident with discontinuance of parenteral glucose infusion. In one patient studied in detail, low levels of hepatic glycogen and normal levels of serum insulin suggest glycogen depletion as the mechanism for hypoglycemia. In seven non-hypoglycemic infants with pyloric stenosis, hepatic glycogen contents were within normal limits. Hypoglycemia should be suspected when the infant develops any unusual or unexplained symptoms following operation. Immediate treatment with intravenous glucose infusion should be initiated and continued until oral feedings are well established.