In which part of India is hypertrophic pyloric stenosis observed more and It’s surgeries are performed more Give me epidemiology and numbers
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"Pyloric Stenosis, Hypertrophic"[MeSH Terms] AND India
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"Pyloric Stenosis, Hypertrophic"[MeSH Terms] AND "incidence"
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infantile hypertrophic pyloric stenosis India incidence Kashmir North India vs South India region
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PMID: 2253430
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infantile hypertrophic pyloric stenosis Kashmir OR Punjab OR "North India" prevalence pyloromyotomy series Indian children
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pyloric stenosis infantile Kashmir OR Chandigarh OR Lucknow OR Delhi
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"Pyloric Stenosis, Hypertrophic"[MeSH Terms] AND (Kashmir OR "North India" OR Indian)
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Kashmir infantile hypertrophic pyloric stenosis high incidence Indian study pyloromyotomy cases per year
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I couldn't find any source that gives region-wise (state or zone) incidence or surgical volume for hypertrophic pyloric stenosis (HPS) in India. I searched the textbook library, PubMed and the web. India has no national registry for it, and the Indian literature is mostly single-centre surgical series. So I can't honestly name one part of India where it is commoner or where more pyloromyotomies are done.
What the sources do support
- The only dedicated Indian series I found: Sharma et al. 1990, Clin Pediatr reported 58 consecutive infants operated on at a North Indian tertiary centre (the abstract doesn't name the hospital).
- Male predominance was stronger than in Western series.
- A pyloric "tumour" was palpable in 89%.
- Only 34.5% were first-born, against the usual first-born excess in the West.
- Postoperative vomiting occurred in 13.8%, and there were no wound infections.
- Air-contrast radiography confirmed the diagnosis in doubtful cases.
- Large paediatric surgery centres: these are mostly in North India (for example AIIMS Delhi, PGIMER Chandigarh, SGPGI Lucknow). That makes it likely the published North Indian case counts reflect referral volume, not true regional incidence. This is my inference, not a finding from the sources.
- Race: the condition is less common in Asian and Black populations than in White populations (patient.info and Medscape, below). Indian rates are therefore expected to be below Western rates, but no source gives an Indian rate.
General epidemiology (global figures, since Indian figures are unavailable)
| Parameter | Figure |
|---|---|
| Incidence in White infants | About 0.1-0.4%, or 1.5-4 per 1,000 live births (Mulholland and Greenfield's Surgery, 7e is not the source; the figure is from Mulholland and Greenfield's Surgery, 7e, Clinical Presentation; Medscape gives the range) |
| Overall incidence quoted in textbooks | About 1 in 250 to 1 in 300 live births (Tintinalli's Emergency Medicine; Quick Compendium of Clinical Pathology) |
| Fischer's Mastery of Surgery, 8e | 1-4 per 1,000 live births, slowly falling in the US, Germany and New Zealand |
| Lower rates | Black, Asian and Hispanic populations (Medscape) |
| Sex | Male:female about 2:1 to 5:1, with more than 80% male in Tintinalli's |
| Family history | About 7% of children of affected parents (Mulholland); about 6% of siblings (Robbins) |
| Age at presentation | Usually 4-6 weeks, rare after 8-10 weeks in term infants (Fischer's) |
| Other risk factors | First-born, bottle-feeding (OR about 2.3), maternal smoking, macrolide exposure, caesarean birth, prematurity |
| German pyloromyotomy data | 2.34 per 1,000 boys and 0.52 per 1,000 girls, with the incidence nearly halving from 2005 to 2017 (PMC8026414) |
Recent evidence check: PubMed showed no recent systematic review or meta-analysis that changes these figures. The recent ones were on recurrent HPS (PMID 41196118) and antibiotic prophylaxis in pyloromyotomy (PMID 39503899).
How to get actual Indian numbers
- Look at hospital-based series from individual paediatric surgery departments (AIIMS, PGIMER, SGPGI, Kashmir and South Indian centres).
- Check the Indian Journal of Pediatrics, Journal of Indian Association of Pediatric Surgeons and Pediatric Surgery International.
- Use HMIS or NFHS births data as the denominator for any incidence calculation.
If you tell me the purpose (exam, paper or thesis), I can help you design a search or a data-collection plan for region-wise rates.
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