Congenital hypertrophic pyloric stenosis (CHPS)

Misnomer

•Idiopathic

•Genetic & Environmental factors

Hypertrophy of the circular muscle of

the pylorus( dueodenem is normal)

First born male child

Males 4:1

Onset at 2-8 weeks of age, commonly at around one month of age

Coffee ground vomitus due to associated gastritis

Starvation stools Dehydration & weight loss

Ultrasound abdomen

to look for the thickened >3.5mm and

elongated>15mm pylorus(doughnut sign)

Gold standard at present, but needs an experienced

sonologist

Elongated narrow pyloric channel

Hypochloremic hypokalemic metabolic alkalosis

Dehydration, alkalosis & electrolytes to be corrected prior to surgery – may take upto 24 hours

Fluid - 5% dextrose in 0.45 normal saline containing 20 to 40 mEq/L of potassium

Feeds can be started as soon as 6 hours

post operatively

No long term complications

( 2 cm transverse incison after identifyin

prepylric vein. wound infetion wound

dehisene h’ge duod perforation (s urg

complications)