Increased Incidence of Hypertrophic Pyloric Stenosis in Esophageal Atresia Patients

Nicole Wilhelmina Gerarda van Beelen; Daphne S. Mous; Erwin Brosens; Annelies de Klein; Cornelis P. van de Ven; John Vlot; Hanneke IJsselstijn; Rene Wijnen

doi:10.1055/s-0033-1352527

European Journal of Pediatric Surgery, Table of Contents

Eur J Pediatr Surg 2014; 24(01): 020-024
DOI: 10.1055/s-0033-1352527

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Increased Incidence of Hypertrophic Pyloric Stenosis in Esophageal Atresia Patients

Nicole Wilhelmina Gerarda van Beelen

¹Department of Pediatric Surgery, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands

,

Daphne S. Mous

¹Department of Pediatric Surgery, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands

,

Erwin Brosens

¹Department of Pediatric Surgery, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands

²Department of Clinical Genetics, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands

,

Annelies de Klein

²Department of Clinical Genetics, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands

,

Cornelis P. van de Ven

¹Department of Pediatric Surgery, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands

,

John Vlot

¹Department of Pediatric Surgery, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands

,

Hanneke IJsselstijn

¹Department of Pediatric Surgery, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands

,

Rene Wijnen

¹Department of Pediatric Surgery, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands

› Author Affiliations

Abstract

Introduction Around half of patients with esophageal atresia (EA) have additional congenital anomalies. Hypertrophic pyloric stenosis (HPS) in these patients is less known, with only 36 cases reported in the past literature. This retrospective study aimed to establish the incidence and clinical presentation of EA patients in combination with HPS in our hospital.

Materials and Methods A retrospective study was based on the medical histories from all patients with EA who underwent surgical repair in our hospital from 1988 through 2012.

Results Of 267 patients with EA, 20 also developed HPS (7.5%). The latter group showed male predominance, 90 versus 60% in the EA without HPS group. The first symptoms of HPS were mostly vomiting and/or feeding intolerance (n = 19). The diagnosis was mostly delayed, with a median of 6 days (range, 1–21 days).

Conclusions This is the first report on the high incidence of HPS in a large series of EA patients. The incidence found is 30 times higher than that in the normal population. HPS should be considered when patients show recurrent or persisting vomiting and feeding intolerance after surgery. The reason for the higher incidence should be further investigated.

Keywords

esophageal atresia - hypertrophic pyloric stenosis - risk factors - incidence - pyloromyotomy

Full Text

References

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