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Pyloric stenosis, infantile hypertrophic, 1(IHPS1)

MedGen UID:
357978
Concept ID:
C1867403
Disease or Syndrome
Synonyms: IHPS1; PYLORIC STENOSIS, INFANTILE
 
Monarch Initiative: MONDO:0008355
OMIM®: 179010

Definition

Infantile pyloric stenosis is the most common condition requiring surgical intervention in the first year of life. It typically presents in infants 2 to 6 weeks after birth. Clinically the disorder is characterized by projectile vomiting, visible gastric peristalsis, and a palpable pyloric tumor (summary by Everett et al., 2008). Mortality was high until successful treatment by pyloromyotomy was developed by Ramstedt (1912). Genetic Heterogeneity of Infantile Hypertrophic Pyloric Stenosis Multiple susceptibility loci have been implicated in IHPS including IHPS1 on chromosome 12q, IHPS2 (610260) on chromosome 16p13-p12, IHPS3 (612017) on chromosome 11q14-q22, IHPS4 (300711) on chromosome Xq23, and IHPS5 (612525) on chromosome 16q24. [from OMIM]

Clinical features

From HPO
Failure to thrive
MedGen UID:
746019
Concept ID:
C2315100
Disease or Syndrome
Failure to thrive (FTT) refers to a child whose physical growth is substantially below the norm.
Pyloric stenosis
MedGen UID:
18780
Concept ID:
C0034194
Pathologic Function
Pyloric stenosis, also known as infantile hypertrophic pyloric stenosis, is an uncommon condition in infants characterized by abnormal thickening of the pylorus muscles in the stomach leading to gastric outlet obstruction. Clinically infants are well at birth. Then, at 3 to 6 weeks of age, the infants present with projectile vomiting, potentially leading to dehydration and weight loss.
Projectile vomiting
MedGen UID:
67442
Concept ID:
C0221151
Sign or Symptom
Vomiting that ejects the gastric contents with great force.
Hypochloremic metabolic alkalosis
MedGen UID:
152850
Concept ID:
C0740895
Disease or Syndrome

Professional guidelines

PubMed

El-Gohary Y, Abdelhafeez A, Paton E, Gosain A, Murphy AJ
Pediatr Surg Int 2018 Jan;34(1):21-27. Epub 2017 Oct 13 doi: 10.1007/s00383-017-4196-y. PMID: 29030700
Lauriti G, Cascini V, Chiesa PL, Pierro A, Zani A
Eur J Pediatr Surg 2018 Oct;28(5):393-399. Epub 2017 Jul 12 doi: 10.1055/s-0037-1604116. PMID: 28701002
Jobson M, Hall NJ
Semin Pediatr Surg 2016 Aug;25(4):219-24. Epub 2016 May 10 doi: 10.1053/j.sempedsurg.2016.05.004. PMID: 27521712

Recent clinical studies

Etiology

Choi G, Je BK, Kim YJ
Korean J Radiol 2022 Jan;23(1):124-138. doi: 10.3348/kjr.2021.0111. PMID: 34983099Free PMC Article
Staerkle RF, Lunger F, Fink L, Sasse T, Lacher M, von Elm E, Marwan AI, Holland-Cunz S, Vuille-Dit-Bille RN
Cochrane Database Syst Rev 2021 Mar 9;3(3):CD012827. doi: 10.1002/14651858.CD012827.pub2. PMID: 33686649Free PMC Article
Zeng L, Xu P, Choonara I, Bo Z, Pan X, Li W, Ni X, Xiong T, Chen C, Huang L, Qazi SA, Mu D, Zhang L
Eur J Clin Pharmacol 2020 Dec;76(12):1709-1721. Epub 2020 Jul 17 doi: 10.1007/s00228-020-02956-3. PMID: 32681202Free PMC Article
Galea R, Said E
Neonatal Netw 2018 Jul;37(4):197-204. Epub 2018 Jul 1 doi: 10.1891/0730-0832.37.4.197. PMID: 30567916
Smith C, Egunsola O, Choonara I, Kotecha S, Jacqz-Aigrain E, Sammons H
BMJ Open 2015 Dec 9;5(12):e008194. doi: 10.1136/bmjopen-2015-008194. PMID: 26656010Free PMC Article

Diagnosis

Choi G, Je BK, Kim YJ
Korean J Radiol 2022 Jan;23(1):124-138. doi: 10.3348/kjr.2021.0111. PMID: 34983099Free PMC Article
Rich BS, Dolgin SE
Pediatr Rev 2021 Oct;42(10):539-545. doi: 10.1542/pir.2020-003277. PMID: 34599053
Zaghal A, El-Majzoub N, Jaafar R, Aoun B, Jradi N
Pediatr Ann 2021 Mar;50(3):e136-e141. Epub 2021 Mar 1 doi: 10.3928/19382359-20210215-01. PMID: 34038653
Galea R, Said E
Neonatal Netw 2018 Jul;37(4):197-204. Epub 2018 Jul 1 doi: 10.1891/0730-0832.37.4.197. PMID: 30567916
Reust CE, Williams A
Am Fam Physician 2016 May 15;93(10):830-6. PMID: 27175718

Therapy

Zaghal A, El-Majzoub N, Jaafar R, Aoun B, Jradi N
Pediatr Ann 2021 Mar;50(3):e136-e141. Epub 2021 Mar 1 doi: 10.3928/19382359-20210215-01. PMID: 34038653
Staerkle RF, Lunger F, Fink L, Sasse T, Lacher M, von Elm E, Marwan AI, Holland-Cunz S, Vuille-Dit-Bille RN
Cochrane Database Syst Rev 2021 Mar 9;3(3):CD012827. doi: 10.1002/14651858.CD012827.pub2. PMID: 33686649Free PMC Article
Iijima S, Ueno D, Baba T, Ohishi A
BMC Pediatr 2018 Sep 3;18(1):290. doi: 10.1186/s12887-018-1270-0. PMID: 30176827Free PMC Article
Lauriti G, Cascini V, Chiesa PL, Pierro A, Zani A
Eur J Pediatr Surg 2018 Oct;28(5):393-399. Epub 2017 Jul 12 doi: 10.1055/s-0037-1604116. PMID: 28701002
Smith C, Egunsola O, Choonara I, Kotecha S, Jacqz-Aigrain E, Sammons H
BMJ Open 2015 Dec 9;5(12):e008194. doi: 10.1136/bmjopen-2015-008194. PMID: 26656010Free PMC Article

Prognosis

Zeng L, Xu P, Choonara I, Bo Z, Pan X, Li W, Ni X, Xiong T, Chen C, Huang L, Qazi SA, Mu D, Zhang L
Eur J Clin Pharmacol 2020 Dec;76(12):1709-1721. Epub 2020 Jul 17 doi: 10.1007/s00228-020-02956-3. PMID: 32681202Free PMC Article
van den Bunder FAIM, van Wijk L, van Woensel JBM, Stevens MF, van Heurn LWE, Derikx JPM
Paediatr Anaesth 2020 Jul;30(7):749-758. Epub 2020 Jun 18 doi: 10.1111/pan.13879. PMID: 32298502Free PMC Article
Hendricks CM, Edgerton CA, Lesher AP
Am Surg 2018 Sep 1;84(9):e354-e356. PMID: 30269705
Al-Ansari A, Altokhais TI
Pediatr Int 2016 Jul;58(7):619-21. Epub 2016 Jul 7 doi: 10.1111/ped.12958. PMID: 27389044
Downey EC Jr
Semin Pediatr Surg 1998 Nov;7(4):220-4. doi: 10.1016/s1055-8586(98)70034-4. PMID: 9840902

Clinical prediction guides

Sullivan KJ, Chan E, Vincent J, Iqbal M, Wayne C, Nasr A; Canadian Association of Paediatric Surgeons Evidence-Based Resource
Pediatrics 2016 Jan;137(1) Epub 2015 Dec 30 doi: 10.1542/peds.2015-2550. PMID: 26719292
Peters B, Oomen MW, Bakx R, Benninga MA
Expert Rev Gastroenterol Hepatol 2014 Jul;8(5):533-41. Epub 2014 Apr 10 doi: 10.1586/17474124.2014.903799. PMID: 24716658
Graham KA, Laituri CA, Markel TA, Ladd AP
J Pediatr Surg 2013 Oct;48(10):2175-9. doi: 10.1016/j.jpedsurg.2013.04.023. PMID: 24094977
Hauben M, Amsden GW
Drug Saf 2002;25(13):929-42. doi: 10.2165/00002018-200225130-00004. PMID: 12381214
Downey EC Jr
Semin Pediatr Surg 1998 Nov;7(4):220-4. doi: 10.1016/s1055-8586(98)70034-4. PMID: 9840902

Recent systematic reviews

Staerkle RF, Lunger F, Fink L, Sasse T, Lacher M, von Elm E, Marwan AI, Holland-Cunz S, Vuille-Dit-Bille RN
Cochrane Database Syst Rev 2021 Mar 9;3(3):CD012827. doi: 10.1002/14651858.CD012827.pub2. PMID: 33686649Free PMC Article
Zeng L, Xu P, Choonara I, Bo Z, Pan X, Li W, Ni X, Xiong T, Chen C, Huang L, Qazi SA, Mu D, Zhang L
Eur J Clin Pharmacol 2020 Dec;76(12):1709-1721. Epub 2020 Jul 17 doi: 10.1007/s00228-020-02956-3. PMID: 32681202Free PMC Article
van den Bunder FAIM, van Wijk L, van Woensel JBM, Stevens MF, van Heurn LWE, Derikx JPM
Paediatr Anaesth 2020 Jul;30(7):749-758. Epub 2020 Jun 18 doi: 10.1111/pan.13879. PMID: 32298502Free PMC Article
Lauriti G, Cascini V, Chiesa PL, Pierro A, Zani A
Eur J Pediatr Surg 2018 Oct;28(5):393-399. Epub 2017 Jul 12 doi: 10.1055/s-0037-1604116. PMID: 28701002
Smith C, Egunsola O, Choonara I, Kotecha S, Jacqz-Aigrain E, Sammons H
BMJ Open 2015 Dec 9;5(12):e008194. doi: 10.1136/bmjopen-2015-008194. PMID: 26656010Free PMC Article

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