Aldosterone and 17-hydroxycorticosteroid Excretion Following Ramstedt's Operation.
نویسنده
چکیده
The management of infants with pyloric stenosis has local variations. In this department a regime of simplicity has been adopted in which the patient is disturbed as little as possible. The diagnosis is made on palpation of a pyloric 'tumour' during a test feed, and only rarely is diagnostic assistance sought from a barium meal. A gastric lavage is done not less than four hours before operation. Pyloromyotomy is performed under general or local anaesthesia according to the surgeon's preference and the child is returned to the medical ward. Feeding is recommenced 4 hours after operation with 8 ml. half-cream National Dried Milk alternating hourly with half-strength physiological saline in unrestricted quantities. The volume of milk is gradually increased and also the interval between feeds until on the third post-operative day 45 ml. milk is being given 4-hourly. Water at this stage is given instead of saline. On subsequent days the volume of each milk feed is increased by 15 ml. until an appropriate full feed is reached. The child is discharged on the 5th post-operative day and returns on the 12th day for removal of sutures. Breast-fed infants are given expressed breast milk and allowed home usually on the 2nd postoperative day to continue breast-feeding. The sutures are also removed on the 12th post-operative day. Biochemical studies are not done routinely and parenteral fluid and electrolyte replacements are undertaken only in the infrequent cases in which dehydration is severe. During the past 4 years 58 cases, on average, have been treated annually in this unit with one death (a mortality rate of less than 0 5%). The present study was designed to assess the adrenocortical response to the acute stress of pyloromyotomy as measured by the urinary 17hydroxycorticosteroid excretion, and to determine the level of free aldosterone excretion in infants. Material and Methods
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عنوان ژورنال:
- Archives of disease in childhood
دوره 40 211 شماره
صفحات -
تاریخ انتشار 1965