İnfantil Hipertrofik Pilor Stenozu Gelişiminde Mevsimsel Etki

Abstract

Objective: The aim of this report was to determine if seasonal variation exists in the incidence of pyloric stenosis and to review the management of infantile hypertrophic pyloric stenosis (IHPS) in a single tertiary pediatric hospital over a seven-year period. Material and Methods: We conducted a retrospective chart review of all patients who underwent pyloromyotomy between October 2004 and October 2011. Patient data and laboratory results on admission were recorded from medical charts. The total and postoperative length of stay was calculated from the date of admission, surgery and discharge. Patients were divided into four groups according to seasons as winter, spring, summer and autumn. Results: A total of 55 pyloromyotomies were performed. Forty-seven patients were male (85.5%) and 8 were female (14.5%). The age distribution of the patients varied from 3 weeks to 13 weeks (median 6 weeks). There was no perioperative mortality. Oral feeding was achieved by 24 hours in 78.2% of infants and there was persistent vomiting in only 30.9%. There was no significant difference between the groups in terms of age, gender, weight, plasma pH, HCO3, Cl-, and K+ values; in addition, ultrasonographic findings were similar in each group. The highest rate of pyloromyotomy was in spring and the lowest in winter and summer; this difference was statistically significant (p=0.0049). Conclusion: In conclusion, seasonal variation of the hypertrophic pyloric stenosis suggests a possible etiological role for environmental factors and pyloromyotomy is the best treatment of IHPS that can be undertaken safely in specialized pediatric centers.