Surgical management of infantile hypertrophic pyloric stenosis--can it be performed by general surgeons?
BACKGROUND
Debate exists as to whether IHPS can be treated in district general hospitals as effectively as in specialist paediatric surgical units.


OBJECTIVE
To review the surgical treatment of IHPS in babies admitted to a district general hospital under the care of two consultant general surgeons with a paediatric surgical interest.


METHODS
The case notes of 66 babies operated on for IHPS over a 42 month period between April 1995 and September 1998 were retrospectively reviewed. Demographics, operative details, hospital stay, and overall complications were all documented.


RESULTS
Peri-operative complications occurred in 2 patients, both requiring omental patches for duodenal perforation. Nine patients had 1 or 2 episodes of postoperative vomiting; 4 had either a wound or urinary tract infection; and 1 baby developed an incisional hernia. There was no mortality.


CONCLUSIONS
The complication rate seen in this series is comparable to that of specialist centres, and supports current guidelines suggesting that IHPS can be managed by general surgeons with a paediatric surgical interest in a district general hospital.
Maxwell-Armstrong
C A
CA
Department of Surgery, Derby City General Hospital, UK.
Cheng
M
M
Reynolds
J R
JR
Holliday
H W
HW
D005260:Female; D006767:Hospitals, District; D006769:Hospitals, General; D006801:Humans; D006984:Hypertrophy / Q000601:surgery; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications; D011707:Pyloric Stenosis / Q000601:surgery*; D012189:Retrospective Studies; D013038:Specialization