title: Current trends in the diagnosis and treatment of pyloric stenosis.
abstract: OBJECTIVE
  We hypothesized that recent trends towards earlier diagnosis of hypertrophic pyloric stenosis continued throughout the early part of the 21st century.
  
  
  METHODS
  We reviewed the medical records of patients with HPS at a single institution during two periods: 1/03-12/05 and 4/09-7/13.
  
  
  RESULTS
  A total of 433 patients with hypertrophic pyloric stenosis who underwent pyloromyotomy were included (modern cohort = 259; historic = 174). The two cohorts did not differ in terms of age, weight, or median time from symptom onset to physician (5 vs 6.5 days; p = 0.3) or surgeon (7 days for both) evaluation. The percentage of patients who presented late (>7 days of symptoms) (27 % modern vs 25 % historic; p = 0.15) or with an elevated serum bicarbonate (22 % for both; p = 0.8) did not change over time. There was a shift to laparoscopic procedures: 99 % modern vs 57 % historic (p < 0.0001) with no associated change in operative length (28 vs. 27 min; p = 0.06), or operative (3 % for both, p = 0.8) or respiratory (4 vs 2 %, p = 0.4) complications.
  
  
  CONCLUSIONS
  Most infants with hypertrophic pyloric stenosis are diagnosed early, prior to significant electrolyte abnormalities; however, continued improvement in awareness is necessary given that a fourth of patients are diagnosed after over 1 week of symptoms.
authors: Department of Pediatric Surgery, Children's Hospital Colorado, University of Colorado School of Medicine, 12631 E 17th Ave, C302, Aurora, CO, 80045, USA, Shannon.acker@ucdenver.edu.
authors: Shannon N
authors: SN
authors: Acker
authors: Allan J
authors: AJ
authors: Garcia
authors: James T
authors: JT
authors: Ross
authors: Stig
authors: S
authors: Somme
mesh_terms: D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000639:trends*; D008297:Male; D011707:Pyloric Stenosis / Q000175:diagnosis / Q000601:surgery*; D011708:Pylorus / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome