RECHERCHES SCIENTIFIQUES

LAPRISE EN CHARGE DE LASTÉNOSE HYPERTROPHIQUE DU PYLORE

Référence946
Année2015
TypeThèse
Lien document
AuteurSaddari A
DisciplineCentre Hospitalier Universitaire Mohammed VI d'Oujda
EncadrantBenhaddou H

The hypertrophic pyloric stenosis is a benign surgical affection of the newborn and the infant. Its surgical treatment is well codified. The objective of this study was to make an overall assessment of the HPS in these various aspects epidemiologic,genetic, clinical, paraclinic, therapeutic and evolutionary, and by analyzing them to appreciate the consistency of some of our results with some etiopathogenic theories on the one hand, and on the other hand to evaluate our care of this pathology. We made a retrospective study about 30 cases of HPS, admitted to the department of paediatric surgical hospital Al Farabi and in the CHU of Oujda, between 2010 and 2015, whose diagnosis was confirmed by abdominal ultrasound. The targeted parameters were collected from files of patients and treated by software SPSS. The results obtained were compared with the literature. The sex ratio was of 2,4/1 with male predominance, 50% of patients were firstborn, the age of the onset of symptoms was on average of 18+/-10 days, the age of the diagnosis was on average of 43.10 +/- 26.44 days. Dehydration was found in 81,5% of our patients. 66.7% of patients had a fall in the weight curve. The pyloric olive was palpated in 14,8% of cases. Abdominal ultrasound was carried out for all our patients. 8 patients had an open pyloromyotomie performed through a circumumbilical approach. 2 duodenal mucosal perforations occurred and were repaired in the same surgical time. 04 post-operative complications were listed. The post-operative duration of hospitalization was on average of 2 days. Our results, in comparison with the other studies, noted that the delay in diagnosis is still present. The care of the HPS is increasingly controlled. Its diagnosis must be evoked in the face of milk vomiting in every newborn or infant which was healthy before, justifying an abdominal ultrasound. The extramuqueuse pylorotomy is the treatment of choice. Morbidity is low with an excellent prognosis