PDF herunterladen
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
1   Department of Pediatric Surgery, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands
,
Daphne S. Mous
1   Department of Pediatric Surgery, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands
,
Erwin Brosens
1   Department of Pediatric Surgery, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands
2   Department of Clinical Genetics, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands
,
Annelies de Klein
2   Department of Clinical Genetics, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands
,
Cornelis P. van de Ven
1   Department of Pediatric Surgery, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands
,
John Vlot
1   Department of Pediatric Surgery, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands
,
Hanneke IJsselstijn
1   Department of Pediatric Surgery, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands
,
Rene Wijnen
1   Department of Pediatric Surgery, Erasmus MC–Sophia Children's Hospital, Rotterdam, The Netherlands
› Institutsangaben
Weitere Informationen

Publikationsverlauf

14. Mai 2013

02. Juli 2013

Publikationsdatum:
27. August 2013 (online)

    Lizenzen und Reprints

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
 

  • References

  • 1 Pedersen RN, Calzolari E, Husby S, Garne E. EUROCAT Working group. Oesophageal atresia: prevalence, prenatal diagnosis and associated anomalies in 23 European regions. Arch Dis Child 2012; 97 (3) 227-232
    CrossrefPubMedGoogle Scholar
  • 2 Oddsberg J, Lu Y, Lagergren J. Aspects of esophageal atresia in a population-based setting: incidence, mortality, and cancer risk. Pediatr Surg Int 2012; 28 (3) 249-257
    CrossrefPubMedGoogle Scholar
  • 3 Somppi E, Tammela O, Ruuska T , et al. Outcome of patients operated on for esophageal atresia: 30 years' experience. J Pediatr Surg 1998; 33 (9) 1341-1346
    CrossrefPubMedGoogle Scholar
  • 4 Solomon BD. VACTERL/VATER association. Orphanet J Rare Dis 2011; 6: 56
    CrossrefPubMedGoogle Scholar
  • 5 Solomon BD, Bear KA, Kimonis V , et al. Clinical geneticists' views of VACTERL/VATER association. Am J Med Genet A 2012; 158A (12) 3087-3100
    CrossrefPubMedGoogle Scholar
  • 6 Pandya S, Heiss K. Pyloric stenosis in pediatric surgery: an evidence-based review. Surg Clin North Am 2012; 92 (3) 527-539 , vii–viii
    CrossrefPubMedGoogle Scholar
  • 7 Krogh C, Gørtz S, Wohlfahrt J, Biggar RJ, Melbye M, Fischer TK. Pre- and perinatal risk factors for pyloric stenosis and their influence on the male predominance. Am J Epidemiol 2012; 176 (1) 24-31
    CrossrefPubMedGoogle Scholar
  • 8 MacMahon B. The continuing enigma of pyloric stenosis of infancy: a review. Epidemiology 2006; 17 (2) 195-201
    CrossrefPubMedGoogle Scholar
  • 9 Panteli C. New insights into the pathogenesis of infantile pyloric stenosis. Pediatr Surg Int 2009; 25 (12) 1043-1052
    CrossrefPubMedGoogle Scholar
  • 10 Everett KV, Chioza BA, Georgoula C, Reece A, Gardiner RM, Chung EM. Infantile hypertrophic pyloric stenosis: evaluation of three positional candidate genes, TRPC1, TRPC5 and TRPC6, by association analysis and re-sequencing. Hum Genet 2009; 126 (6) 819-831
    CrossrefPubMedGoogle Scholar
  • 11 Krogh C, Biggar RJ, Fischer TK, Lindholm M, Wohlfahrt J, Melbye M. Bottle-feeding and the risk of pyloric stenosis. Pediatrics 2012; 130 (4) e943-e949
    CrossrefPubMedGoogle Scholar
  • 12 Zamakhshary MF, Dutta S, To T, Stephens D, Langer JC, Wales PW. Seasonal variation of hypertrophic pyloric stenosis: a population-based study. Pediatr Surg Int 2011; 27 (7) 689-693
    Google Scholar
  • 13 Mahon BE, Rosenman MB, Kleiman MB. Maternal and infant use of erythromycin and other macrolide antibiotics as risk factors for infantile hypertrophic pyloric stenosis. J Pediatr 2001; 139 (3) 380-384
    PubMedGoogle Scholar
  • 14 Jahanshahifard S, Ahmadpour-Kacho M, Esmaeili Dooki MR, Osia S, Hadipoor A, Zahedpasha Y. Pyloric stenosis complicating esophageal atresia. Shiraz E Med J 2011; 12 (1) 44-47
    PubMedGoogle Scholar
  • 15 Zhang ZB. Esophageal atresia/tracheoesophageal fistula complicated by hypertrophic pyloric stenosis: a case report. Zhongguo Dang Dai Er Ke Za Zhi 2010; 12 (1) 71-72
    PubMedGoogle Scholar
  • 16 Oğuzkurt P, Tanyel FC, Haliloğlu M, Hiçsönmez A. An uncommon association of H-type tracheoesophageal fistula with infantile hypertrophic pyloric stenosis. Turk J Pediatr 1999; 41 (1) 143-146
    PubMedGoogle Scholar
  • 17 Wang JN, Lin CH, Wu MH, Lian JD. Infantile hypertrophic pyloric stenosis after surgery for esophageal atresia with tracheoesophageal fistula. J Formos Med Assoc 1996; 95 (8) 642-643
    PubMedGoogle Scholar
  • 18 Kiliç N, Gürpinar A, Kiriştioğlu I, Doğruyol H. Association of oesophageal atresia and hypertrophic pyloric stenosis. Acta Paediatr 2000; 89 (1) 118-119
    CrossrefPubMedGoogle Scholar
  • 19 Magilner AD. Esophageal atresia and hypertrophic pyloric stenosis: sequential coexistence of disease (case report). AJR Am J Roentgenol 1986; 147 (2) 329-330
    CrossrefPubMedGoogle Scholar
  • 20 Qvist N, Rasmussen L, Hansen LP, Pedersen SA. Development of infantile hypertrophic pyloric stenosis in patients treated for oesophageal atresia. A case report. Acta Chir Scand 1986; 152: 237-238
    PubMedGoogle Scholar
  • 21 Glasson MJ, Bandrevics V, Cohen DH. Hypertrophic pyloric stenosis complicating esophageal atresia. Surgery 1973; 74 (4) 530-535
    PubMedGoogle Scholar
  • 22 Raffensperger J. Gastrointestinal-tract defects associated with esophageal atresia and tracheo-esophageal fistula. Arch Surg 1970; 101 (2) 241-244
    CrossrefPubMedGoogle Scholar
  • 23 Ahmed S. Infantile pyloric stenosis associated with major anomalies of the alimentary tract. J Pediatr Surg 1970; 5 (6) 660-666
    CrossrefPubMedGoogle Scholar
  • 24 Franken Jr EA, Saldino RM. Hypertrophic pyloric stenosis complicating esophageal atresia with tracheoesophageal fistula. Am J Surg 1969; 117 (5) 647-649
    CrossrefPubMedGoogle Scholar
  • 25 Foster GE, Shaw RE. Case of congenital atresia of the oesophagus with infantile pyloric stenosis. Arch Dis Child 1946; 21 (105) 55-56
    CrossrefPubMedGoogle Scholar
  • 26 Gischler SJ, Mazer P, Duivenvoorden HJ , et al. Interdisciplinary structural follow-up of surgical newborns: a prospective evaluation. J Pediatr Surg 2009; 44 (7) 1382-1389
    CrossrefPubMedGoogle Scholar
  • 27 Gross RE. The Surgery of Infancy and Childhood. Philadelphia: WB Saunders; 1953
    Google Scholar
  • 28 Ravitch MM, Barton BA. The need for pediatric surgeons as determined by the volume of work and the mode of delivery of surgical care. Surgery 1974; 76 (5) 754-763
    PubMedGoogle Scholar
  • 29 Visser GH, Eilers PH, Elferink-Stinkens PM, Merkus HM, Wit JM. New Dutch reference curves for birthweight by gestational age. Early Hum Dev 2009; 85 (12) 737-744
    CrossrefPubMedGoogle Scholar
  • 30 Iqbal CW, Rivard DC, Mortellaro VE, Sharp SW, St Peter SD. Evaluation of ultrasonographic parameters in the diagnosis of pyloric stenosis relative to patient age and size. J Pediatr Surg 2012; 47 (8) 1542-1547
    CrossrefPubMedGoogle Scholar
  • 31 Felix JF, Tibboel D, de Klein A. Chromosomal anomalies in the aetiology of oesophageal atresia and tracheo-oesophageal fistula. Eur J Med Genet 2007; 50 (3) 163-175
    CrossrefPubMedGoogle Scholar