title: Recent changes in the features of hypertrophic pyloric stenosis.
abstract: BACKGROUND
  Hypertrophic pyloric stenosis (HPS) is a rare cause of non-bilious vomiting in young infants; the condition requires surgical management. Diagnosis is based on clinical, laboratory, and radiological findings. In the present study, we evaluate recent changes in the features of HPS.
  
  
  METHODS
  We retrospectively reviewed the demographic, clinical, and laboratory data on 56 HPS patients who underwent pyloromyotomy between 1996 and 2015. Patients were divided into two groups according to date of operation (group 1, 1996-2006; group 2, 2007-2015).
  
  
  RESULTS
  Group 1 consisted of 30 patients and group 2, 26. The age at diagnosis was longer in group 2 (43.3 ± 13.1 days) than group 1 (37.4 ± 17.7 days). All diagnoses were confirmed on ultrasonography. Pyloromyotomy was performed on all 56 patients (48 boys, 8 girls). Significant between-group differences were evident in terms of age at onset of vomiting; rate of dehydration; development of palpable olive-shaped abdominal mass; serum urea and creatinine; acid-base status; and air distribution pattern on abdominal radiography (all P < 0.05).
  
  
  CONCLUSIONS
  The frequency of olive-shaped abdominal mass evident on physical examination decreased significantly over time, and was lower than published values. Early diagnosis triggers timely support and surgical intervention, and may thus prevent development of the classical clinical and laboratory findings of late-stage HPS. The remarkable recent advances in ultrasonography and techniques allow HPS to be diagnosed earlier than formerly.
authors.affiliation: Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey.
authors.forename: Unal
authors.initials: U
authors.lastname: Bakal
authors.affiliation: Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sarac
authors.affiliation: Department of Neonatology, Firat University School of Medicine, Elazig, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Aydin
authors.affiliation: Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey.
authors.forename: Tugay
authors.initials: T
authors.lastname: Tartar
authors.affiliation: Department of Pediatric Surgery, Firat University School of Medicine, Elazig, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kazez
mesh_terms: D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010808:Physical Examination; D046248:Pyloric Stenosis, Hypertrophic / Q000175:diagnosis* / Q000601:surgery; D011708:Pylorus / Q000601:surgery; D012189:Retrospective Studies; D014463:Ultrasonography
keywords: Fredet-Ramstedt pyloromyotomy; hypertrophic pyloric stenosis; non-bilious vomiting; olive-shaped abdominal mass; ultrasonography