title: Can the duration of vomiting predict postoperative outcomes in hypertrophic pyloric stenosis?
abstract: OBJECTIVE
  Hypertrophic pyloric stenosis (HPS) is a common cause of gastric outlet obstruction (GOO) in infants. Prolonged GOO is believed to result in acid and electrolyte disturbances, gastric atony, and delayed postoperative recovery. We studied the impact of prolonged vomiting as an indicator of GOO symptoms on the post-operative outcomes in HPS.
  
  
  METHODS
  A retrospective chart review of all patients who underwent pyloromyotomy at a tertiary care center between February 1997 and February 2009.
  
  
  METHODS
  The duration of pre-operative vomiting was correlated with presenting electrolytes and acid-base balances, postoperative time to full feed, postoperative morbidity and duration of hospitalization.
  
  
  RESULTS
  Forty-seven patients were identified. At presentation, the median (range) for duration of symptoms was 14 (3-60) days, and surgeries were performed at 2 (0-6) days after admission. Apart from one case of postoperative wound infection, all patients had an unremarkable recovery. The unusually prolonged duration of vomiting in our cohort did not correlate with the mean (SD) preoperative chloride level of 93.9 (8.8) mEq/L, mean (SD) pH level of 7.5 (0.9), mean postoperative time to full feeding of 31 (15.1) hours, or mean duration of hospitalization of 5.1 (2.2) days.
  
  
  CONCLUSIONS
  Duration of vomiting in HPS at presentation does not seem to have a significant impact on the postoperative outcomes.
authors: Division of Pediatric Surgery, King Saud University, College of Medicine, Riyadh, Saudi Arabia. aljazaeri@yahoo.com
authors: Ayman
authors: A
authors: Al-Jazaeri
authors: Abdullah
authors: A
authors: Al-Shehri
authors: Mohammad
authors: M
authors: Zamakhshary
authors: Abdulrahman
authors: A
authors: Al-Zahem
mesh_terms: D000137:Acid-Base Imbalance / Q000097:blood / Q000209:etiology; D002712:Chlorides / Q000097:blood; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D005260:Female; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000097:blood*; D011379:Prognosis; D046248:Pyloric Stenosis, Hypertrophic / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D020127:Recovery of Function; D013223:Statistics as Topic; D013997:Time Factors; D016896:Treatment Outcome; D014839:Vomiting / Q000097:blood / Q000209:etiology / Q000503:physiopathology
chemical_list: D002712:Chlorides