영아 비후성 유문협착증의 임상적 고찰
Clinical Analysis of the Infantile Hypertrophic Pyloic Stenosis
김해성, 김태화, 전장용, 이해완, 류병윤, 김홍기,
소속 상세정보
김해성 ( Kim Hae-Sung )
한림대학교 의과대학 외과학교실
김태화 ( Kim Tae-Hwa )
한림대학교 의과대학 외과학교실
전장용 ( Jeon Jang-Yong )
한림대학교 의과대학 외과학교실
이해완 ( Lee Hae-Wan )
한림대학교 의과대학 외과학교실
류병윤 ( Ryu Byoung-Yoon )
한림대학교 의과대학 외과학교실
김홍기 ( Kim Hong-Ki )
한림대학교 의과대학 외과학교실
KMID : 0371320040660020128
Abstract
Purpose: Infantile hypertrophic pyloric stenosis (IHPS) is a common surgical emergency of infants that exhibits clearly unique characteristic symptoms, but its etiology and pathogenesis are still obscure. The Fredet-Ramstedt pyloromyotomy has gained worldwide acceptance. The advantages of this operation are immediate solution of the problem and few complication. Cosmetically circumumbilical incision or laparoscopic pyloromytomy can be used.
Methods: Forty cases of IHPS admitted to the Chuncheon Sacrec Heart Hospital from Jan 1997. to Dec 2002 were reviewed retrospectively. These cases underwent Fredet-Ramstedt´s operation.
Results: The most prevalent age group was 21~30 days (10 cases: 25%), mean age was 41.4±9.9 days, and the males to females ratio was 4.7 : 1. Among the 40 cases, 24 (60%) involved the first baby. The mean gestation age was 33.9±1.7 weeks and mean birth weight was 3.3±0.5 Kg. The mean duration of symptom was 4.1±1.6 days. The common symptoms were non-bile stained, projectile vomiting in all cases, an olive-shaped mass in the right upper quadrant abdomen in 21 cases (52.5%), visible peristalsis on epigastrium in 16 cases (40%), and jaundice in 1 case (2.5%). Hypokalemic alkalosis was observed in 3 cases (7.5%). The mean length and thickness of the stenotic canal, as measured in the operation, were 28.8±8.5 mm and 4.9±0.6 mm, respectively. Postoperative complications were one case each (2.5%) pneumonia, wound seroma, and recurrence.
Conclusion: Fredet-Ramstedt´s pyloromyotomy for IHPS is an effective operation after the correction of dehydration and electrolyte imbalance.
키워드
영아 비후성 유문협착증;Fredet-ramstedt 유문근절개술;Infantile hypertrophic pyloric stenosis;IHPS;Fredet-ramstedt´s pyloromyotomy
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