INFANTILE HYPERTROPHIC PYLORIC STENOSIS IN NIGERIA: A MULTICENTER RETROSPECTIVE STUDY.

Abstract

Background: Infantile hypertrophic pyloric stenosis (IHPS) is a disease whose incidence varies across the different races worldwide. This study examined the epidemiology, clinical presentation and management of IHPS in Nigeria. Patients and Methods: A retrospective study of cases of IHPS was conducted across six paediatric surgical centres in Nigeria with complements of at least two paediatric surgeons and high patient turn overs. Data collected were analyzed, the results obtained were expressed in simple percentages, mean ± standard deviation while linear relationships were obtained using Spearman's correlation and the level of significance set at p < 0.05. Results: One hundred and thirty-one patients were managed across the six centres in Nigeria, their ages ranged from 5 days - 44 weeks with a median of 6 weeks. There were 109 (83.2%) boys and 22 (16.8%) girls (M: F = 5:1). Electrolyte derangement was observed in 63(48.1%) patients (hyponatraemia - 42.0%, hypokalaemia - 35.9%, hypochloraemia - 32.1% and metabolic acidosis - 39.7%). The peri-operative mortality rate in this review was 5.3%. Post-operative complications had statistically significant association with longer duration of symptoms before presentation (p = 0.037), presence of jaundice (p = 0.024) and raised levels of creatinine at presentation (p = 0.002). Longer duration of symptoms before presentation (p = 0.037) were significantly associated with mortality. Conclusion: The epidemiology and clinical presentations are still similar to findings from outside Nigeria but comparable to other Low Middle Income Countries and post-operative outcome is also comparably good.