الفهرس 
Anatomy and EmbryologyOnly 14 pages are availabe for public view
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Abstract
Hypertrophic pyloric stenosis is the most common surgical disorder producing emesis in infancy with an incidence of approximately 1-4 for every 1000 live births. Male to female ratio is 4 to 1. Age of incidence is 2-8 weeks.
Diagnosis of hypertrophic pyloric stenosis depends upon the classic clinical features of projectile non bilious vomiting, the presence of palpable pyloric mass, visible gastric waves on the abdomen.
Radiographic examination with either an upper gastrointestinal series or abdominal ultrasonography should be reserved for those patients in whom the pyloric mass cannot be palpated.
Rammestedt in 1912 was the first who described the surgical procedure of pyloromyotomy as a treatment of infantile hypertrophic pyloric stenosis and from that date Rammestedt’s pyloromyotomy is universally accepted as the preferred operation.
This procedure can be performed though a number of different approaches. The classical approach is an upper right transverse skin incision. Upper umbilical fold incision is another approach that was proposed to get an easier exposure to the pyloric mass with a better cosmetic results.
This study was conducted in the period from June 2016 to June 2017 at the General Surgery Department, Menoufiya University Hospital. This prospective randomized study included 20 infants with IHPS, they were 15 males and 5 females, their ages ranged from 25-90 days. Patients were randomly divided into two equal groups (A & B) according to the type of incision used by the closed envelop method. Each group included 10 infants. Patients of group ”A” were subjected to Rammstedt’s pyloromyotomy via the classic upper right transverse incision while patients of group ”B” were subjected to Rammstedt’s pyloromyotomy via the upper umbilical fold incision.