Infantile hypertrophic pyloric stenosis

Infantile hypertrophic pyloric stenosis (IHPS) is one of the most commonly encountered paediatric surgical conditions. It is estimated to affect between 1 and 4 infants per 1,000 births, representing the most common cause of surgical intervention in the first 6 months of life. The exact aetiology remains unclear. It is known to be more common in males (4:1), especially those that are first-born. Abdominal examination can sometimes detect visible stomach peristalsis in the left upper quadrant and the pathognomic sign of an “olive shaped” epigastric mass may be present. In cases of diagnostic uncertainty or where a definitive mass is not felt, ultrasound is the investigation of choice for confirming IHPS, with high sensitivity and specificity. Following appropriate pre-operative optimisation and surgical correction is undertaken. The Ramstedt’s pyloromyotomy con be performed via a right upper quadrant, peri-umbilical, or laparoscopic approach. The vast majority of cases recover quickly with no concerns, with the infant almost invariably discharged soon after treatment. Perforation requiring mucosal repair and incomplete pyloromyotomy requiring re-do surgery as the specific complications.