Infantile Hypertrophic Pyloric Stenosis

Abstract

Infantile hypertrophic pyloric stenosis (IHPS) is a common surgical condition encountered in early infancy. Despite the extensive research, the etiology of IHPS remains still obscure. Genetic, environmental, and hormonal factors have been implicated in the pathogenesis of this condition. In terms of the pathophysiology, abnormalities of smooth muscle cells, growth factors, extracellular matrix, nerve and supporting systems, neurotransmitter, and intestinal cell of Cajal have been also reported. The incidence is approximately 1–5:1,000 with a peak incidence of 2–8 weeks. Also, epidemiologically, wide variations of incidence have been reported with geographic location, season, and ethnic origin. Although extramucosal pyloromyotomy is the procedure of choice, the best way to approach the pylorus is debated – conventional right upper quadrant open procedure, transumbilical approach, and more recently laparoscopic procedure. This chapter outlines the new insights into etiology and pathogenesis and also the important elements necessary to care for the patients in safe and effective manner.