311 results match your criteria Pediatrics Pyloric Stenosis

Environmental exposure in the etiology of infantile hypertrophic pyloric stenosis: a systematic review and meta-analysis.

Pediatr Surg Int 2022 Jul 20;38(7):951-961. Epub 2022 Apr 20.

Department of Occupational Health and Safety, Hacettepe University Institute of Public Health, Ankara, Turkey.

Purpose: To investigate the occupational and environmental factors in the etiology of infantile hypertrophic pyloric stenosis (IHPS).

Methods: Protocol was drafted according to the PRISMA guidelines and registered on PROSPERO (CRD42020152460). A search for a combination of terms related to IHPS, fetus and neonates, and environmental exposure was performed for studies published between 2000 and 2020 in the EMBASE, Pubmed, and MEDLINE databases. Read More

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An Infant With Hereditary Fructose Intolerance and a Novel Presentation of Disseminated Intravascular Coagulopathy following Pyloromyotomy.

J Pediatr Hematol Oncol 2022 Mar 30. Epub 2022 Mar 30.

Division of Neonatology, Department of Pediatrics.

Hereditary fructose intolerance is a rare autosomal recessive metabolic disorder characterized by liver failure, renal tubulopathy, growth retardation, and occasionally death upon exposure to fructose. We present a 2-month-old male infant diagnosed with pyloric stenosis who developed disseminated intravascular coagulopathy following pyloromyotomy. Unexplained persistent coagulopathy, acute liver failure, and metabolic dysfunction led to whole-exome sequencing, which revealed compound heterozygous variants in ALDOB (p. Read More

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Stratifying features for diagnosing hypertrophic stenosis on ultrasound: a diagnostic accuracy study.

ANZ J Surg 2022 05 8;92(5):1153-1158. Epub 2022 Apr 8.

Department of Paediatric Surgery, Monash Children's Hospital, Melbourne, Victoria, Australia.

Background: Our aims were to determine if the diagnostic threshold for diagnosing hypertrophic pyloric stenosis (HPS) on ultrasound scan (USS) should be adjusted based on birth weight (BW), current weight (CW), gestational age (GA), chronological age (CA) or corrected gestational age (CGA).

Methods: All patients who underwent either an USS and pyloromyotomy (Group 1) or an USS for possible HPS (Group 2) at our tertiary centre between July 2013 and June 2019 were identified. Ideal threshold values are identified by measuring Youden's Index (J = sensitivity + specificity - 1; higher is better). Read More

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Hypertrophic Pyloric Stenosis in Dizygotic Twins: Case Report.

Ishan Poudel

Cureus 2021 Dec 11;13(12):e20350. Epub 2021 Dec 11.

Pediatrics, Woodhull Medical Center, Brooklyn, USA.

Infantile hypertrophic pyloric stenosis (IHPS) is a disorder encountered in infancy that is caused by hypertrophy of the musculature of the pylorus of the stomach. It may present as partial or complete gastric outlet obstruction. Multiple previous literatures have discussed the incidences and variability in the presentation of IHPS. Read More

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December 2021

Factors Associated with Pyloric Hypertrophy Severity and Post-operative Feeding and Nutritional Recovery in Infantile Hypertrophic Pyloric Stenosis.

Biomed J 2022 Jan 4. Epub 2022 Jan 4.

Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Taoyuan City, 33305, Taiwan; Chang Gung University College of Medicine, Taoyuan City, 33302, Taiwan.

Background: To examine factors that affect the severity of pyloric hypertrophy, post-operative feeding and nutritional recovery in infantile hypertrophic pyloric stenosis (IHPS).

Material And Methods: Medical records of infants diagnosed with IHPS at a single tertiary center between 2009 and 2018 were retrospectively reviewed. Clinical characteristics, biochemistry data and outcome were assessed for their association with the severity of pyloric hypertrophy and post-operative recovery. Read More

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January 2022

8-Day-old male infant with bilious emesis and hematochezia.

Am J Emerg Med 2022 Apr 9;54:325.e1-325.e2. Epub 2021 Oct 9.

Division of Pediatric Emergency Medicine, University of Minnesota Medical School, Minneapolis, MN, United States of America.

The differential diagnosis for bilious emesis and hematochezia in newborns is broad and includes structural abnormalities (malrotation with volvulus, atresia, pyloric stenosis, intussusception), infectious colitis, necrotizing enterocolitis, milk protein intolerance, vascular malformations, and other bleeding disorders. Here we report a case of bilious emesis and hematochezia in an 8-day-old male infant who was ultimately found to have goat's milk protein intolerance after an extensive workup ruling out other pathology. There have been limited studies that examine goat's milk protein intolerance in pediatric patients, and to our knowledge, our paper presents the youngest patient presenting with bilious emesis related to goat's milk intake. Read More

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Saline-Aided Ultrasound Versus Upper Gastrointestinal Series in Neonates and Infants With Suspected Upper Gastrointestinal Obstruction: A Prospective Multicenter Comparative Study.

AJR Am J Roentgenol 2022 03 13;218(3):526-533. Epub 2021 Oct 13.

Department of Medical Ultrasound, Institute for Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan Rd 2, Guangzhou 510080, PR China.

. Use of upper gastrointestinal (UGI) series to diagnose UGI obstruction in neonates and infants has raised concern about increased radiation sensitivity of developing organs. . Read More

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Evaluating the validity of ultrasound in diagnosing hypertrophic pyloric stenosis: a cross-sectional diagnostic accuracy study.

ANZ J Surg 2021 11 5;91(11):2507-2513. Epub 2021 Oct 5.

Department of Paediatric Surgery, Monash Children's Hospital, Melbourne, Victoria, Australia.

Background: Our aims were to evaluate the ultrasound scan (USS) criteria in diagnosing hypertrophic pyloric stenosis (HPS), determine the best diagnostic threshold values for pyloric muscle thickness (PMT) and pyloric canal length (PCL), and assess the accuracy of flow through the pylorus.

Methods: All patients who underwent pyloromyotomy at our tertiary paediatric surgery centre between July 2013 and June 2019 were identified (Group 1). All patients undergoing an USS to investigate for a possible HPS and did not undergo pyloromyotomy were also identified (Group 2). Read More

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November 2021

Pyloric stenosis in an infant.

Aust J Gen Pract 2021 10;50(10):744-746

MBBS, MD, DCH, AFRACMA, FRACP, Head of Paediatric Department, Nepean Hospital, NSW; Conjoint Lecturer, Sydney Medical School Nepean, Discipline of Paediatrics, The University of Sydney, NSW.

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October 2021

Feasibility of Point-of-Care Ultrasound for Diagnosing Hypertrophic Pyloric Stenosis in the Emergency Department.

Pediatr Emerg Care 2021 Nov;37(11):550-554

From the Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul.

Objectives: This study aimed to investigate the feasibility of point-of-care ultrasound (POCUS) for diagnosing hypertrophic pyloric stenosis (HPS) in the emergency department (ED).

Methods: A retrospective study was conducted in infants aged younger than 90 days who were brought to the ED due to vomiting between January 2015 and December 2019. Of these, infants who were clinically suspected of having HPS and underwent ultrasound were included and categorized into 3 groups: POCUS only, POCUS followed by radiologist-performed ultrasound (RADUS), and RADUS only. Read More

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November 2021

Breastmilk Feeding during the First 4 to 6 Months of Age and Childhood Disease Burden until 10 Years of Age.

Nutrients 2021 Aug 17;13(8). Epub 2021 Aug 17.

Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju 61469, Korea.

Background: Breastfeeding is recommended due to its beneficial effects on human health. However, the effect of breastfeeding on health differs, resulting in various childhood diseases.

Objective: Our purpose was to investigate the association between breastfeeding at least in the first 4 months and the subsequent development of 15 certainly defined childhood diseases until 10 years of age, the all-cause hospitalization rate and growth at 6-7 years of age. Read More

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The phenotypic spectrum of AMER1-related osteopathia striata with cranial sclerosis: The first Canadian cohort.

Am J Med Genet A 2021 12 20;185(12):3793-3803. Epub 2021 Aug 20.

Division of Clinical and Metabolic Genetics, Department of Pediatrics, London Health Sciences, Schulich School of Medicine, Western University, London, Ontario, Canada.

Osteopathia striata with cranial sclerosis (OSCS; OMIM# 300373) is a rare X-linked disorder caused by mutations of the AMER1 gene. OSCS is traditionally considered a skeletal dysplasia, characterized by cranial sclerosis and longitudinal striations in the long bone metaphyses. However, OSCS affects many body systems and varies significantly in phenotypic severity between individuals. Read More

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December 2021

Infantile hypertrophic pyloric stenosis following maternal exposure to Fluoxetine: A case report.

Asian J Psychiatr 2021 11 8;65:102804. Epub 2021 Aug 8.

Department of Paediatric Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, 576104, India. Electronic address:

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November 2021

Neonatal Community-acquired Raoultella Ornithinolytica Septicemia: A Case Report and Review of the Literature.

Pediatr Infect Dis J 2021 10;40(10):e370-e373

From the Division of Neonatology, Department of Pediatrics.

Raoultella ornithinolytica is an opportunistic, aquaphilic and Gram-negative bacterium. Immune deficiency states and indwelling catheters provide a basis for most of the infections arising. R. Read More

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October 2021

A patient with POLA1 splice variant expands the yet evolving phenotype of Van Esch O'Driscoll syndrome.

Eur J Med Genet 2021 Aug 10;64(8):104261. Epub 2021 Jun 10.

Division of Genetics, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029 , India. Electronic address:

Van Esch-O'Driscoll syndrome (VEODS) is a rare cause of syndromic X-linked intellectual disability characterised by short stature, microcephaly, variable degree of intellectual disability, and hypogonadotropic hypogonadism. To date, heterozygous hypomorphic variants in the gene encoding the DNA Polymerase α subunit, POLA1, have been observed in nine patients from five unrelated families with VEODS. We report a three-year-old child with VEODS having borderline intellectual disability due to a novel splice site variant causing exon 6 skipping and reduced POLA1 expression. Read More

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Hypertrophic Pyloric Stenosis: 10 Years' Experience with Standard Open and Laparoscopic Approach.

Pediatr Gastroenterol Hepatol Nutr 2021 May 4;24(3):265-272. Epub 2021 May 4.

Department of Surgery, Dentistry, Paediatrics and Gynecology, Woman and Child Hospital; Division of Pediatric Surgery, University of Verona, Verona, Italy.

Purpose: Hypertrophic pyloric stenosis (HPS) is the most common cause of gastric obstruction in newborns. Extra-mucosal pyloromyotomy can be performed through a small laparotomy or laparoscopy. The aim of this study was to compare the two surgical techniques. Read More

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Infant presenting with pyloric stenosis and autosomal recessive polycystic kidney disease at 36 weeks' postmenstrual age (PMA).

BMJ Case Rep 2021 May 19;14(5). Epub 2021 May 19.

Pediatrics, Monmouth Medical Center, Long Branch, New Jersey, USA.

This case report describes a premature male infant born after a pregnancy complicated by oligohydramnios of unknown aetiology but otherwise unremarkable prenatal scans. He had sudden onset of projectile emesis and severe hypertension in the third week of life, and further investigations revealed both pyloric stenosis and polycystic kidneys, at just 36 weeks' postmenstrual age (PMA). His course thereafter was complicated by severe refractory hypertension requiring multiple antihypertensive agents in order to gain control, although his renal function remained normal. Read More

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Analysis of Pediatric Surgery Using the National Healthcare Insurance Service Database in Korea: How Many Pediatric Surgeons Do We Need in Korea?

J Korean Med Sci 2021 May 10;36(18):e116. Epub 2021 May 10.

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background: In the past, general surgeons (GSs) without a pediatric surgical subspecialty often performed surgery on children and, even now, GSs are performing many pediatric surgeries. We aimed to investigate the involvement of pediatric surgeons (PSs) and GSs in pediatric surgery, compare the outcomes of surgery in the neonatal intensive care unit (NICU), and estimate the appropriate PS workforce in Korea.

Methods: We used surgical data from the National Health Insurance Service database that was collected from patients under the age of 19 years in hospitals nationwide from January 2002 to December 2017. Read More

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Protocol: A systematic review and meta-analysis of the role of fetal and infantile environmental exposure in etiopathogenesis of infantile hypertrophic pyloric stenosis.

PLoS One 2021 16;16(2):e0247003. Epub 2021 Feb 16.

Departments of Occupational Health and Safety, Hacettepe University Institute of Public Health, Ankara, Turkey.

Infantile hypertrophic pyloric stenosis (IHPS) is one of the hallmark pediatric surgical diseases. However, its etiology remains incompletely understood. By systematically reviewing the literature, we aim to clarify the effect of the effect of occupational and environmental factors and role of nitric oxide (NO) metabolism in the etiopathogenesis of IHPS. Read More

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Getting it right first time: implementation of laparoscopic pyloromyotomy without a learning curve.

Ann R Coll Surg Engl 2021 Feb;103(2):130-133

Birmingham Children's Hospital, Birmingham, UK.

Introduction: Laparoscopic pyloromyotomy is now an accepted procedure for the treatment of pyloric stenosis. However, it is clear that during the implementation period there are significantly higher incidences of mucosal perforation and incomplete pyloromyotomy. We describe how we introduced a new laparoscopic procedure without the complications associated with the learning curve. Read More

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February 2021

New insight into clinical heterogeneity and inheritance diversity of FBLN5-related cutis laxa.

Orphanet J Rare Dis 2021 01 28;16(1):51. Epub 2021 Jan 28.

Department of Medical Genetics, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: FBLN5-related cutis laxa (CL) is a rare disorder that involves elastic fiber-enriched tissues and is characterized by lax skin and variable systemic involvement such as pulmonary emphysema, arterial involvement, inguinal hernias, hollow viscus diverticula and pyloric stenosis. This type of CL follows mostly autosomal recessive (AR) and less commonly autosomal dominant patterns of inheritance.

Results: In this study, we detected a novel homozygous missense variant in exon 6 of FBLN5 gene (c. Read More

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January 2021

The incidence of infantile hypertrophic pyloric stenosis nearly halved from 2005 to 2017: analysis of German administrative data.

Pediatr Surg Int 2021 May 20;37(5):579-585. Epub 2021 Jan 20.

Klinik und Poliklinik für Kinderchirurgie, Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.

Purpose: Some paediatric surgical diseases showed a declining incidence in recent years, among which hypertrophic pyloric stenosis has been particularly striking shortly in the years after the millennium. We aimed to assess whether this development continued over the following decade, as it might offer the chance to better understand the underlying reasons.

Methods: We analysed data files obtained from the German federal statistics office for principal diagnosis of hypertrophic pyloric stenosis and pyloromyotomies from 2005 to 2017. Read More

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Prolonged neuromuscular block after rocuronium administration in laparoscopic pyloromyotomy patients: A retrospective bayesian regression analysis.

Paediatr Anaesth 2021 03 22;31(3):290-297. Epub 2021 Jan 22.

Department of Pediatric Anesthesiology, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA.

Background: Infants undergoing pyloromyotomy are at a high risk of aspiration, making rapid sequence induction the preferred method of induction. Since succinylcholine use in infants can be associated with complications, rocuronium is frequently substituted despite its prolonged duration of action.

Aims: To examine the likelihood of non-reversibility to neostigmine at the end of surgery in laparoscopic pyloromyotomies and its correlation to both rocuronium dose and out of operating room time. Read More

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Epidural versus general anesthesia for open pyloromyotomy in infants: A retrospective observational study.

Paediatr Anaesth 2021 04 29;31(4):452-460. Epub 2021 Jan 29.

Department of Anesthesia, General Intensive Care Medicine and Pain Therapy, Medical University of Vienna, Vienna, Austria.

Background: Thoracic epidural anesthesia for open infantile hypertrophic pyloric stenosis surgery is a controversial issue in the presence of little comparative data.

Aims: To compare this approach to general anesthesia for desaturation events (≤90% oxygen saturation) and absolute values of minimal oxygen saturation, minimal heart frequency, operating-room occupancy time, and durations of surgery in a retrospective study design.

Methods: Data were retrieved for patients with infantile hypertrophic pyloric stenosis managed by thoracic epidurals under sedation or general anesthesia with rapid sequence induction between 01/2007 and 12/2017. Read More

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Leveraging a phenome-wide approach to identify novel exposure-birth defect associations: A proof of concept using maternal smoking and a spectrum of birth defects.

Birth Defects Res 2021 03 4;113(5):439-445. Epub 2020 Dec 4.

Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.

Background: There are often questions about the impact of exposures on a range of birth defects, but there are few rigorous approaches for evaluating these associations. Using maternal smoking as an example we applied a phenome-wide association study (PheWAS) approach to evaluate the impact of this exposure on a comprehensive range of birth defects.

Methods: Cases were obtained from the Texas Birth Defects Registry for the period 1999-2015. Read More

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ACR Appropriateness Criteria® Vomiting in Infants.

J Am Coll Radiol 2020 Nov;17(11S):S505-S515

Specialty Chair, Riley Hospital for Children Indiana University, Indianapolis, Indiana.

Vomiting in infants under the age of 3 months is one of the most common reasons for parents to seek care from their doctor or present to an emergency room. The imaging workup that ensues is dependent on several factors: age at onset, days versus weeks after birth, quality of emesis, bilious or nonbilious vomiting, and the initial findings on plain radiograph, suspected proximal versus distal bowel obstruction. The purpose of these guidelines is to inform the clinician, based on current evidence, what is the next highest yield and most appropriate imaging study to pursue a diagnosis. Read More

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November 2020

Safety of azithromycin in pediatrics: a systematic review and meta-analysis.

Eur J Clin Pharmacol 2020 Dec 17;76(12):1709-1721. Epub 2020 Jul 17.

Department of Pharmacy/Evidence-based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, 610041, China.

Purpose: To evaluate the toxicity of azithromycin in neonates, infants, and children.

Methods: A systematic review was performed for relevant studies using Medline (Ovid), PubMed, Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, and International Pharmaceutical Abstracts. We calculated the pooled incidence of adverse drug reactions (ADRs) associated with azithromycin based on prospective studies (RCTs and prospective cohort studies) and analyzed the risk difference (RD) of ADRs between azithromycin and placebo or other antibiotics using meta-analysis of RCTs. Read More

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December 2020

Duodenal Stenosis: A Diagnostic Challenge in a Neonate With Poor Weight Gain.

Cureus 2020 Jun 11;12(6):e8559. Epub 2020 Jun 11.

Pediatrics, The Brooklyn Hospital Center, Brooklyn, USA.

Cases of isolated duodenal stenosis in the neonatal period are minimally reported in pediatric literature. Causes of small bowel obstruction such as duodenal atresia or malrotation with midgut volvulus have been well documented and are often diagnosed due to their acute clinical presentation. Duodenal stenosis, however, causes an incomplete intestinal obstruction with a more indolent and varying clinical presentation thus making it a diagnostic challenge. Read More

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Postoperative Opioid Analgesia Impacts Resource Utilization in Infants Undergoing Pyloromyotomy.

J Surg Res 2020 11 8;255:594-601. Epub 2020 Jul 8.

Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA. Electronic address:

Background: Opioid analgesia is often avoided in infants undergoing pyloromyotomy. Previous studies highlight an association between opioid use and prolonged hospitalization after pyloromyotomy. However, the impact of opioid use on healthcare resource utilization and cost is unknown. Read More

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November 2020

Pediatric Surgery Simulation-Based Training for the General Surgery Resident.

J Surg Res 2021 02 16;258:339-344. Epub 2020 Jun 16.

Division of Pediatric Surgery, Department of Surgery, Rush University Medical Center, Chicago, Illinois; Rush Center For Clinical Skills and Simulation, Rush University Medical Center, Chicago, Illinois.

Background: Surgical simulation-based training (SBT) can increase resident confidence and improve performance. SBT in pediatric surgery is in its infancy and often geared toward training pediatric surgery fellows. Since case volume for various pediatric surgery-specific procedures can be low based on the rarity of the pathology involved and the level of care provided by the institution, our aim was to create a pediatric surgery simulation-based curriculum for general surgery residents to address this need. Read More

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February 2021