Neonatal Emergencies II: Infantile Hypertrophic Pyloric Stenosis & Intestinal Obstruction

Abstract

This review focuses on the clinical presentation, diagnosis, preoperative stabilization and intraoperative management of infantile hypertrophic pyloric stenosis (IHPS) and neonatal gastrointestinal obstructions. IHPS poses medical emergency, which demands adequate preoperative optimization of the intravascular status and metabolic derangements before proceeding with surgery. In contrast, malrotation and volvulus require immediate surgical exploration under ongoing aggressive resuscitation in order to minimize further deterioration and preserve bowel length. Congenital anomalies, associated with disorders such as duodenal atresia, malrotation, volvulus, and anorectal malformations, warrant focused examinations to characterize the defect and severity of functional impairment, but they should not delay interventions for which time is a critical factor. This review contains 2 tables, and 41 references. Key words: neonatal, infantile pyloric stenosis, gastrointestinal, vomiting, metabolic, resuscitation, obstruction, malformation, apnea, rapid sequence.