CLINICAL AND PARACLINICAL CHARACTERISTICS OF CHILDREN WITH HYPERTROPHIC PYLORIC STENOSIS TREATED AT THE NATIONAL CHILDREN'S

Long Lê Hoàng, Thanh Nguyễn Hoàng, Hiền Phạm Duy

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Abstract

This study aims to describe the clinical and paraclinical characteristics of pediatric patients diagnosed with hypertrophic pyloric stenosis (HPS) at the National Children’s Hospital between 2018 and 2023 to support paediatricians and surgeons in improving diagnostic accuracy and selecting appropriate treatment strategies. A retrospective analysis was conducted on 46 patients diagnosed with HPS. The findings indicate that the condition predominantly affects male infants (78.3%) and typically presents between the ages of 3 to 6 weeks (82.6%), with a mean age of onset at 26.57 ± 9.91 days. Most patients were diagnosed between 3 and 8 weeks of age (71.8%), with the average time to diagnosis being 42.38 ± 20.73 days. Clinically, all patients (100%) exhibited non-bilious, projectile vomiting of milk or undigested milk, often with a characteristic temporal delay after feeding. On physical examination, a palpable pyloric mass was detected in approximately 52.2% of cases. Plain abdominal radiography frequently revealed gastric dilation with a prominent gastric air bubble (82.6%). Ultrasonographic findings demonstrated that the majority of cases (93.4%) presented with a pyloric canal length of ≥ 16.0 mm and a muscle thickness of ≥ 4.0 mm. Conclusion: Infants presenting with non-bilious vomiting following feeding and, when present, a palpable pyloric mass should be evaluated for hypertrophic pyloric stenosis. In cases with atypical presentations, abdominal radiography and ultrasonography play critical roles in confirming the diagnosis.

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References

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