Management of Infantile Hypertophic Pyloric Stenosis With Open Pyloromyotomy

Background: Infantile hypertrophic pyloric stenosis (IHPS) is a common cause of gastric outlet obstruction in early infancy, primarily affecting males. Prompt diagnosis and surgical intervention are essential to prevent complications and ensure favourable outcomes. Objective of this study was to evaluate the characteristics and outcomes of surgical management of IHPS using open pyloromyotomy. Methods: A case-series conducted at the Paediatric Surgery Department, Bahawal Victoria Hospital, Bahawalpur from 31 Jan to 30 Jun 2023. Forty-seven children aged 1 day to 3 months diagnosed with IHPS and scheduled for open pyloromyotomy were included. Diagnosis was based on non-bilious projectile vomiting and/or palpable pyloric mass, confirmed on ultrasonography. All underwent surgery under general anaesthesia following standard protocols. Results: Of 47 infants, 32 (68.1%) were boys and 15 (31.9%) girls. Mean age was 5.1±3.2 weeks; 34 (72.3%) were aged 2–6 weeks. Preterm birth and Caesarean delivery were recorded in 28 (59.6%) each. Common symptoms included projectile vomiting (100%), weight loss (55.3%), and visible gastric peristalsis (51.1%). Mean surgery duration was 37.3±7.4 minutes. Postoperative vomiting occurred in 16 (34.0%), surgical site infection in 4 (8.5%), and sepsis in 3 (6.4%). Mortality was 6.4%. Conclusion: IHPS predominantly affects boys and presents with projectile vomiting. Open pyloromyotomy resulted in favourable outcomes, though 6.4% mortality was observed. Pak J Physiol 2025;21(2):42?4, DOI: https://doi.org/10.69656/pjp.v21i2.1646