Cambios epidemiológicos y diagnósticos en la estenosis hipertrófica de píloro

Resumen

Introduction: Hypertrophic pyloric stenosis is one of the most common causes of vomiting in infants with significant clinical and metabolic impact, more pronounced as time progresses. The objective of this study is to detect epidemiological changes and diagnostic development of hypertrophic pyloric stenosis, over a decade. Patients and methods: Retrospective descriptive study of 141 patients treated in our hospital between 2000 and 2009, inclusive. Several epidemiological, clinical and laboratory variables were collected and compared between two periods of time chosen at random to detect changes: 2000-2004 and 2005-2009. Results: The incidence of 1.92 ‰ live births, remained stable over time, with a male:female ratio of 6:1. There were also no changes in the porcentage of patient weight loss. However, we detected a decrease of 33% in the age of infants at the time of diagnosis as well as an increase of patients with less than 5 days lasting symptoms. The decrease of ultrasound measurements, lenght and wall thickness lead to a decline in the diagnosis of large and therefore more evolved pylori. As for the analytical parameters studied, we only appreciated a decrease in creatinine values. Conclusions: The diagnosis of hypertrophic pyloric stenosis has experienced an anticipation. Patients are diagnosed younger with less hypertrophied pylorus and therefore less clinical and laboratory alteration. Diagnosis has shifted significantly from clinical to the ultrasound one.