Infantile Hypertrophic Pyloric Stenosis: Unveiling Global Patterns, Diagnostic Frontiers, and Evolving Management Paradigms

Abstract

Background: Infantile Hypertrophic Pyloric Stenosis (IHPS) is the leading etiology of gastric outlet obstruction in infancy, with progressive pyloric musculature hypertrophy. A comprehensive compilation of its global epidemiological trends, spectrum of investigations, varying therapeutic outcomes, and complications is required for refining clinical practice. Objective and Aim: The current systematic review and meta-analysis specifically sought to follow up the research query: "What are current epidemiological trends, diagnostic strategy, treatment results, and associated complications of infantile hypertrophic pyloric stenosis in different global populations, and what are implications of the findings for future clinical practice and research, and more specifically the integration of technological innovations?" Methods: Systematic research was performed in PubMed, Scopus, and Embase. After rigorous PRISMA-guided screening, 14 studies were chosen for systematic review. Directed meta-analysis was performed on 3 studies aiming specifically for male effect size proportion. Data extraction included epidemiological features, diagnosis methods, treatment patterns, and complication rates. Quality assessment was performed utilizing the proper tools pertinent to each study design. Results: The systematic review invariably showed a very high male predominance, with male-to-female ratios usually 4.25:1 to 4.7:1, and infants presenting at around 5 weeks of age. Ultrasonography was confirmed as the gold standard investigation. Surgical pyloromyotomy was maintained as the universally accepted definitive treatment. Complications were varied, with wound infection rates up to 10.8%, prolonged ileus events up to 3.9%, and very rare duodenal perforations, perhaps as high as 9.5%. Though mortality was usually low, there were occurrences reported by some series. The meta-analysis of the male proportion showed an overall effect size of almost 0.78 (95% CI: 0.69, 0.88). Conclusion: -IHPS exhibits a uniform presence of epidemiological characteristics at a global level, supported by competent diagnostic and treatment methods. Outcome and complication variations underscore the influence of heterogeneous healthcare environments. Future research should emphasize the need for standardized outcome reporting, refer to long-term consequences, and methodically incorporate emerging technologies, including AI-supported diagnostics and telemedicine monitoring, to maximize patient care.