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hypertrophic pyloric stenosis (IHPS, HPS)
Etiology:
- erythromycin (8-fold risk in 1st 1 weeks of life)
- bottle-fed infants at higher risk for pyloric stenosis than breast-fed infants [5]
Pathology:
- hypertrophy & hyperplasia of the circular muscle layer of the pylorus
- defective pyloric relaxation & increased pyloric smooth muscle mass havebeen suggested to be responsible for gastric-outlet obstruction
- bottle-fed infants ingest a larger volume of milk & retain it for a longer period of time in the stomach; burden of overfeeding may challenge the pylorus muscle & lead to hypertrophy [5]
Epidemiology:
- infants
- 1-5 per 1000 live births in whites
- male:female ratio of 4:1
- most frequent disorder requiring surgery in the 1st year of life
Clinical manifestations:
- persistent vomiting 2-12 weeks after birth
Management:
- surgical correction
General
gastric outlet obstruction (pyloric stenosis)
Database Correlations
OMIM 179010
References
- Journal Watch 22(16):128, 2002
Cooper WO, Griffin MR, Arbogast P, Hickson GB, Gautam S, Ray WA.
Very early exposure to erythromycin and infantile hypertrophic
pyloric stenosis.
Arch Pediatr Adolesc Med. 2002 Jul;156(7):647-50.
PMID: 12090829
- OMIM :accession 179010
- Wikipedia; Note: Nitric oxide synthase entry
http://en.wikipedia.org/wiki/Nitric_oxide_synthase
- UniProt :accession P29475
- Krogh C et al
Bottle-feeding and risk of pyloric stenosis.
Pediatrics, Sept 17, 2012
PMID: 22945411
http://pediatrics.aappublications.org/content/early/2012/08/28/peds.2011-2785.full.pdf+html