Value of clinical, laboratory, and ultrasonographic data for the diagnostic hypertrophic pyloric stenosis in newborns
DOI:
https://doi.org/10.15574/PS.2025.3(88).3440Keywords:
hypertrophic pyloric stenosis, diagnosis, electrolytes balance, ultrasonographyAbstract
Infantile hypertrophic pyloric stenosis (IHPS) characterized by the narrowing of pyloric channel that determined the appearance of nonbilious vomiting and requires the surgery. Non-specific clinical symptoms of the disease in the early neonatal period caused some challenges of the IHPS diagnosis, which determined the necessity of complex evaluation results of clinical, laboratory, and ultrasonographic (USG) data.
Aim - to analysis of correlation of US parameters with clinical and laboratory data at HPSN.
Materials and methods. This study based on the analysis of medical file record of 39 newborns that were operated at 2020-2024 years due to IHPS. Diagnosis established on the base of results of clinical, laboratory, and USG investigation. In this study, all patients were separated on three groups: 1st - without disorders of electrolytes balance, 2nd - with mild, and 3rd - with severe imbalance. Ultrasonographically measured pyloric muscle thickness (PMT), pyloric canal length (PCL), pyloric diameter (PD), pyloric rate (PR) - PMT divided by PD, and pyloric index (PI) - PMT multiplied by PCL. Results of the study were evaluated by the statistical program StatPlus: mac, AnalystSoft Inc. (version v8).
Results. Infants with an existing imbalance had higher values of all USG parameters of the pyloric canal compared to patients without an imbalance, however this difference was significant only for PCL. Analysis of the relationship between the duration of the disease and changes in electrolyte balance and pyloric canal size showed a direct correlation with levels of base excess (BE), pH, PCL, and PI, but chloride and sodium level were inversely correlated. Presence of olive sign associated by the increased all pyloric canal dimensions, however this increase was not statistically significant.
Conclusions. Electrolyte imbalance appeared in patients with hypertrophic pyloric stenosis, by that it may be absent in some of them. Levels of BE, chloride, sodium, pH, and some of pyloric canal indices, such as PCL and PI, in patients with severe imbalance clear correlated with disease duration. Clinical signs of pyloric clear correlate with base excess, indices of PCL and PI, and in case of severe imbalance the clear correlation of all pyloric canal dimensions, except its diameter, were noted.
The research was carried out in accordance with principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of Clinical centre of children’s healthcare hospital «OHMATDYT». The informed agreement of parents was obtained for conducting the study.
The authors declare no conflict of interest.
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