TREATMENT OUTCOME AND ASSOCIATE FACTORS OF INFANTILE HYPERTROPHIC PYLORIC STENOSIS AT HIWOTFANA COMPERHENSIVE UNIVERSITY HOSPITAL AND JIGJIGA UNIVERSITY SHEIK HASSEN YABAREE REFERRAL HOSPITAL.

Abstract

ABSTRACT Background. Infantile hypertrophic pyloric stenosis is an anomaly whose etiology is not clear, but It is characterized by progressive hypertrophy of the circular muscles of the pylorus with consequent obstruction of the gastric outflow, mostly in neonates and infants under the age of 1 year. the visible gap of prolonged duration of illness, prolonged preoperative hospital stay and high proportion of dehydration and electrolyte disturbance, in patients with Infantile Hypertrophic Pyloric Stenosis, motivated me to make this study at Hiwot Fana Specialized University Hospital and Jigjiga University Sheik Hassen Yabare Referral Hospital. Objectives: -To assess the Treatment outcome and associate factors of infantile pyloric sphincter stenosis among pediatric patients admitted to HFCSUH and JUSHYRH for the last 3 years from January 1,2020 to December 31,2022. Data was collected from (November, 1 to 31,2022) Methodology: The study was conducted on cases of infantile hypertrophic pyloric stenosis admitted to HFCSH and JUSHYRH from January, 2020- December, 2022. The study design was a cross sectional with sample size of 78. Bivariate analysis and Multivariate logistic regression was employed to assess the treatment outcome and associating factors of infantile hypertrophic pyloric stenosis. The significance of association between dependent and independent variables was declared by using odds ratio with 95% confidence interval and P value <0.05. Results:A total of 78 IHPS patients were admitted and operated during the period of study. Among these, 8 were excluded from the study due to incomplete data. Out of 70 patients, 56 (80 %) were males and 14 (20 %) females with a male to female ratio of 4:1. The duration of symptoms before admission ranged from 2 to 60 days (median 20 days). The most common symptoms reported were non-bilious vomiting (100%) and poor weight gain 61.4%). Majority (78.6%) of our patients had electrolyte imbalance. Potassium imbalance was the most common among the patients seen. The diagnosis of IHPS was made by ultrasound. The treatment was Ramstedt’s pyloromyotomy in all cases. Conclusion:This study has demonstrated that infantile pyloric stenosis is 4 times more common in males compared to females and is more common among first born neonates compared to higher order neonates.Delayed presentation, prolonged preoperativehospital stay, surgical site infection and high proportion of dehydration and electrolyte disturbance were the main predictors of poor outcome.