İnfantil Hipertrofik Pilor Stenozu
Özet
İnfantil hipertrofik pilor stenozunun (IHPS) etiyolojisi kesin olarak aydınlatılamamış olmakla birlikte, hastalığın ortaya çıkışında genetik yatkınlık ile çevresel faktörlerin birlikte rol oynadığı düşünülmektedir. Pilor stenozu, çocuk cerrahisi pratiğinde sık karşılaşılan bir durum olup, ultrasonografinin yaygın kullanımı sayesinde kolaylıkla tanı konulabilmektedir. Uygun sıvı ve elektrolit replasmanı ile gerçekleştirilen yeterli preoperatif resüsitasyon sonrasında, postoperatif süreç genellikle sorunsuz ilerlemektedir. Ameliyat sonrası uygun izlem ve erken başlanan beslenme, çoğu hastada 24–48 saat içerisinde güvenli ve zamanında taburculuğa olanak tanımaktadır. Dehidratasyon ve elektrolit dengesizlikleri düzeltildikten sonra gerçekleştirilen Ramstedt piloromiyotomisinin prognozu oldukça iyidir ve zamanında müdahale edilen olgularda sonuçlar genellikle mükemmeldir. Cerrahi sırasında perforasyonun önlenmesi ve yeterli miyotominin sağlanması, başarılı ve tutarlı sonuçlar elde edilmesinde temel unsurlardır. IHPS cerrahisi acil bir girişim olarak değerlendirilmemeli; operasyon, serum elektrolit düzeyleri ve asit-baz dengesi normale getirildikten sonra planlanmalıdır.
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