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PubMed1978

Association of antral diaphragms and hypertrophic pyloric stenosis.

In a 2 year period at Children's Hospital of Philadelphia, seven human infants and a baby orangutan all presented with a previously unreported association of a prepyloric membrane and hypertrophic pyloric stenosis. In the humans, the pyloric stenosis was the obstructive lesion, and in the orangutan, the web. We also report a 6-year-old patient with previous pyloromyotomy who presented because of prolonged retention of a marble in the stomach by an associated antral membrane.

Animals↗
PubMed2004

Does valsalva retinopathy occur in infants? An initial investigation in infants with vomiting caused by pyloric stenosis.

OBJECTIVE: Retinal hemorrhages (RHs) are 1 manifestation of child abuse, and although they often are considered to be diagnostic of abuse in a young child, there are other potential causes. RHs have been described in association with valsalva maneuver, such as forceful vomiting or coughing. Our aim was to describe the incidence of RH in infants with vomiting caused by pyloric stenosis. METHODS: A prospective, descriptive study was conducted of infants who underwent pyloromyotomy for hypertrophic pyloric stenosis (HPS). Dilated retinal examinations were performed, and the findings were documented. RESULTS: A total of 100 infants with HPS were evaluated. Eighty-four infants were male, 92 were white, and 21 had a family history of pyloric stenosis. Thirty-seven examinations were performed in the operating room. Eighteen examinations were confirmed by a second investigator, and 3 children had dilated eye examinations documented independently by a pediatric ophthalmologist. No RHs were identified (0 of 100; 95% confidence interval: 0%-3%). One patient had facial petechiae, and 2 had subconjunctival hemorrhage. Electrolyte levels were abnormal in 63 patients. In 89 cases, the emesis was described as projectile. Patients varied in the number of episodes of emesis, with 30% of patients having >100 episodes of emesis before diagnosis. One patient had a respiratory arrest associated with vomiting in the emergency department and required bag-valve mask ventilation. CONCLUSIONS: No RHs were identified in 100 infants with vomiting caused by HPS. These results suggest that RHs do not result from forceful vomiting in infants.

Child Abuse↗
PubMed1981

Probable autosomal dominant infantile pyloric stenosis in a large kindred.

The proposita was operated on in this hospital in 1980 for pyloric stenosis, at the age of 13 days, after vomiting had started 5 days previously, and the diagnosis had been confirmed on radiological investigation. Her older sister and two male cousins of the father had the same operations in Israel in infancy. The other nine affected individuals in the family were known to have had projectile vomiting for several months in infancy, and two of them died in infancy. They were all born in the Jewish community in Georgia, U.S.S.R. The male:female sex ratio was 2:2 for the operated cases, and 4:5 for those projectile vomiting history. There was no skipping of a generation. This family indicates that pyloric stenosis can exceptionally be inherited as a simple autosomal dominant trait.

Female↗
PubMed1990

[Infantile hypertrophic pyloric stenosis].

We present 40 patients operated consecutively for pyloric stenosis during an 8-year period (1981-88). The most common symptom was projectile vomiting, which occurred in 92.5% of the cases. On examination only three patients had a palpable hypertrophic pylorus. In 39 patients, a preoperative x-ray examination with contrast was necessary to confirm the diagnosis. A pyleromyotomy was performed in all patients. We discuss the diagnostic routines and the results of our treatment.

Adolescent↗
PubMed1976

Genetic analyses of pyloric stenosis suggesting a specific maternal effect.

Data on pyloric stenosis are analysed by multiple threshold methods that incorporate the sex effect. The polygenic model of inheritance is rejected; the single major locus model can only account for 37% of the cases having a genetic aetiology, requiring an environmental effect to account for the remainder of the cases. A maternal-fetal interaction for gastrin production and sensitivity is postulated to explain all the existing data. The empirical risk figures given are considered to be the most accurate basis for genetic counselling until additional studies provide a sound biological basis for a quantitative genetic model.

Female↗
PubMed1991

[Pyloric stenosis in the dog: developments in its surgical treatment and retrospective study in 47 patients].

Diagnosis and treatment of pyloric stenosis in the dog are described. The most common causes in 47 dogs were hypertrophic and functional pyloric stenosis. These conditions were mostly seen in young, male dogs of brachycephalic breeds. In contrast with the literature no indications were found for a predisposition in miniature breeds. Hypertrophic stenosis was treated successfully with the Fredet-Ramstedt pyloromyotomy. Functional stenosis and hypertrophic gastritis were mainly treated with the Heineke-Mikulicz pyloroplasty; good results were obtained in more than half of the cases.

Animals↗
PubMed1983

[Malignant pyloric stenosis caused by cancer in para-pyloric ectopic pancreas].

Gastrointestinal symptoms with epigastric pain, nausea and loss in weight occasionally occur in patients with ectopic pancreas. Although ectopic pancreas is often found in the stomach, carcinoma in this ectopy is rare. This paper reports a case of pancreatic carcinoma arising in ectopic pancreas located in the gastric wall and causing pyloric obstruction. Malignant pyloric obstruction was the only radiographic sign. Microscopic examination led to the final diagnosis.

Adenocarcinoma↗
PubMed1995

Laparoscopic pyloromyotomy for infantile hypertrophic pyloric stenosis: report of 11 cases.

Pyloromyotomy remains the standard of care for the treatment of infantile hypertrophic pyloric stenosis. Open pyloromyotomy is effective and is the gold-standard technique. The authors report on the techniques of laparoscopic pyloromyotomy. The clinical courses of the first 11 infants treated with laparoscopic pyloromyotomy we with the courses of 14 infants treated recently with open pyloromyotomy. The average surgical time for the laparoscopic group was 25.4 minutes. The average time (postoperatively) until full feedings was 19.0 hours. In the open pyloromyotomy group the average surgical time was 26.1 minutes, and the time until full feedings was 23.2 hours. These results are not significantly different. When compared with open pyloromyotomy, the laparoscopic approach appears to be equally safe and effective, with superior cosmetic results. The authors believe that laparoscopic pyloromyotomy is an excellent alternative procedure for the management of hypertrophic pyloric stenosis.

Eating↗
PubMed1998

Pyloric stenosis due to Crohn's disease.

Gastroduodenal involvement by Crohn's disease is relatively rare and occasionally causes pyloric stenosis, for which medical therapy may be ineffective and surgery may be required. We report on a 44-year-old man patient in whom corticosteroids had a marked effect in reducing pyloric stenosis caused by Crohn's disease. A proton-pump inhibitor was not effective, and Helicobacter pylori was negative.

Adult↗
PubMed1978

Psychological determinants of infantile pyloric stenosis.

In order to investigate the possible contribution of maternal emotional stress to the aetiology of infantile pyloric stenosis, 100 mothers of affected infants, 100 "normal" controls who had not sought medical advice at any time concerning feeding problems, and 50 mothers of children with spina bifida were interviewed. All completed the Life Events Inventory, which gives a quantitative measurement of stressful life events during a given period. In addition, the subject mothers and "normal" controls completed form A of the Eysenck Personality Inventory, the Multiple Affect Adjective Check list, and Linear Analogue Scales for the subjective measurement of satisfaction with feeding and distress caused by feeding problems. A highly significant difference was found between the number of items given a heavy weighting on the Life Events Inventory experienced by the subjects and both control groups. This was particularly marked during the last trimester of pregnancy. Personality assessment was very similar in all groups, but maternal anxiety scores were higher in the subjects than in the controls. It is concluded that hypertrophic pyloric stenosis occurs unduly frequently in infants of normal mothers who have been subjected to particularly stressful events during pregnancy.

Adult↗
PubMed1988

Pyloric stenosis in a patient with progressive systemic sclerosis.

A 64-year-old Japanese woman with progressive systemic sclerosis (PSS) who developed severe pyloric stenosis is described. The conservative treatments brought only the temporary symptomatic relief, and pyloroplasty became necessary. No ulcerative lesions or tumors were found in the resected stomach or duodenum specimens implicated for stenosis. The histological examinations revealed edema and replacement fibrosis in the pyloric ring. The possible mechanisms of pyloric stenosis are discussed.

Female↗
PubMed1977

[The effect of pyloric stenosis on the development of stress ulcers in the rat].

The authors examined in rats the importance of pyloric stenosis for the development of spontaneous acute ulcers and stress ulcers in the stomach. Spontaneous superficial lesions arise only during the first 20 days. They apparently signify an intensified narrowing by postoperative swelling with mechanical stimulation of gastrin secretion in the antrum. They were not observed during later periods. Chronic ulcers did not develop. Stress ulcers caused by immobilization were more frequently seen in rats with pyloric narrowing than without. Vagotomy protected the rats with pyloric stenosis from stress ulcer, although not as certain as in control animals.

Animals↗
PubMedDate not supplied

Infantile hypertrophic pyloric stenosis and subsequent ulcer dyspepsia. A follow-up study of medically and surgically treated patients.

Infantile hypertrophic pyloric stenosis was treated in 324 cases in 1950-1966. At follow-up 19-35 years later, 296 of the patients could be traced, and 284 replied to a questionnaire concerning ulcer dyspepsia. Among the 80 patients who had been medically treated for pyloric stenosis, the prevalence of ulcer dyspepsia was 13.8%, and in the 204 surgically treated patients it was 9.3%. The difference was not statistically significant.

Adult↗
PubMed2006

Diagnosis and therapy of primary hypertrophic pyloric stenosis in adults: case report and review of literature.

Adult idiopathic hypertrophic pyloric stenosis (AIHPS) is a misleading anatomic and radio-clinical entity of unknown etiology. Only about 200 cases have been reported in the literature. It is a benign disease resulting from hypertrophy of the circular fibers of the pyloric canal. Despite the recent progress in radiography and endoscopy, it is very hard to define hypertrophic stenosis in adults. Differentiation of primary from secondary pyloric stenosis is frequently a task of the pathologist rather than the surgeon. The main therapy is surgical, although endoscopic dilatation has been tried. There remains controversy over the best surgical approach. A case is reported of a 48-year-old male patient with AIHPS who was subjected to distal gastrectomy. This paper discusses the possible causes of the disorder, the recommended diagnostic steps, and the different surgical approaches.

Biopsy↗
PubMedDate not supplied

Congenital hypertrophic pyloric stenosis in twins.

The current report has been devoted to the presentation of the diagnosis and operative treatment of congenital hypertrophic pyloric stenosis in monozygotic twins. Special attention has been paid to a number of theories aiming to explain the aetiology and the mechanisms contributing to the development of congenital hypertrophic pyloric stenosis.

Diseases in Twins↗
PubMed1996

Through-the-scope balloon dilation for pyloric stenosis: long-term results.

BACKGROUND: Through-the-scope balloon dilation has been used for treatment of benign pyloric stenosis; however, long-term results are lacking in the literature. METHOD: A retrospective analysis using the Kaplan-Meier method. RESULTS: Between November 1986 and December 1993, 54 patients underwent through-the-scope balloon dilations for pyloric stenosis. The mean age was 57.5 years. There were 5 (9.3%) initial treatment failures due to tight stenoses and perforations from dilation occurred in 4(7.4%) patients. Forty-five (83.3%) patients underwent successful dilation. Four patients developed rapid restenoses and were found to have malignant obstructions. Forty-one patients entered our study. Time at risk commenced on the date of initial dilation. The end point was defined at the time at which patients presented with recurrent obstruction or other ulcer complications. The median follow-up period was 39 months. The ulcer complication-free probability at 3 months, and at 1, 2, and 3 years was 79.1%, 73.4%, 69.3%, and 54.7%, respectively. In all, 21 (51.2%) patients required subsequent surgery: 18 for recurrent obstructions, 2 for interval perforations, and 1 for bleeding. CONCLUSION: While through-the-scope balloon dilation may palliate symptoms of obstruction, recurrent obstruction and other ulcer complications are common. It should be reserved only for patients at high risk for operative surgery.

Adult↗