Clinical features of congenital hypertrophic pyloric stenosis

Objective To explore the clinical features of congenital hypertrophic pyloric stenosis(CHPS)in Chinese Han population,provide the evidence for diagnosis,treatment and epidemiological investigation.Methods Three hundred and seven hospitalized patients with CHPS were retrospectively reviewed,and data including patient's sex,onset age,body weight,other coexisting congenital defects,pyloric muscle thickness(evaluated by ultrasonograph),serum electrolytes concentration and results of arterial blood gas analysis on admission were collected.According to the duration between first onset and admission,the patients were divided into two groups:early group(less than or equal to 10 days)and later group(more than 10 days).The arterial blood gas,serum electrolyte concentration and average daily weight gain were compared between the two groups.Results There were 262 male and 45 female in 307 patients,the onset age ranged between 1 and 351 days,after 6 extreme cases were excluded,the mean onset age of the remaining 301 cases was 23.8±13.0 days.The birth weight was(3.24±0.44)kg(1.6～4.5 kg);coexisting congenital defects were found in 62 cases(20.2%).Pyloric muscle thickness was(5.4±1.1)mm(3～8 mm).For early group,the rates of hypokalemia,hypochloraemia and hypercapnia were significantly lower than those of later group,while the daily weight increase was significantly greater.Conclusions In Chinese Han population,the onset age of CHPS is 3～5 weeks.The mean pyloric circular muscle thickness is(5.4±1.1)mm,and one-fifths of the patients are accompanied with other congenital difects.For infants with persistent vomiting at the age of 3～5 weeks should be considered CHPS,and go to hospital as soon as possible in order to reduce the incidence of hypokalemia,hypochloraemia and Hypercapnia,and avoid deterioration.