HYPERTROPHIC PYLORIC STENOSIS AT CHILDRENS HOSPITAL OF PITTSBURGH FROM 1912 TO 1967 - A CRITICAL REVIEW OF CURRENT PROBLEMS AND COMPLICATIONS

Review of 1215 patients treated for hypertrophic pyloric stenosis during the period from 1912 to 1967 inclusive, demonstrates that the mortality has decreased to 0.5 per cent and the rate of complications to 9.5 per cent. Infections, usually pneumonia, have been the principle cause of death in the 27 infants who did not recover following pyloromyotomy. Postoperative complications now most commonly observed are incisional infections and gastroenteritis. Roentgen examination was used to aid in the diagnosis of pyloric stenosis in 254 infants. In 154 instances, it was probably unnecessary. When pyloric stenosis is present in an infant with a cleft lip and palate, diagnosis may be difficult and delayed. Such infants require special care. Nine infants in this series required a second pyloromyotomy. Only 35 per cent of the patients in this series never vomited postoperatively. Postoperative vomiting of varied degree occurs frequently after successful pyloromyotomy and probably represents variations in the return of gastric peristalsis. © 1969.