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Results for “PYLORIC STENOSIS”

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At least 343 records · Page 19Linked to original sources
PubMed1982

[Kinetics of intestinal absorption in cases of dumping syndrome following partial gastrectomy and pyloric stenosis (author's transl)].

By means of analyses of intestinal absorption using the modified D-Xylose test the absorption kinetics of nutrients in cases of dumping syndrome after partial gastrectomy and in cases of pyloric stenosis could be traced. There was no decrease of absorption in the small gut. Changes of the intestinal absorption in cases of gastric dumping were caused by rapid gastric emptying. The delayed gastric emptying in cases of pyloric stenosis is followed by a decrease of Xylose resorption due to the reduction of resorption. The D-Xylose-test allows disorders of gastric emptying to be differentiated from those of enteral resorption.

Adult↗
PubMed1986

The improved ultrasound diagnosis of hypertrophic pyloric stenosis.

A prospective study of ultrasound in the diagnosis of idiopathic hypertrophic pyloric stenosis (IHPS) in 200 consecutive infants with persistent vomiting is reported. The criteria evaluated include measurements of the pyloric diameter, muscle thickness and canal length, and observing the function of the pylorus and gastric peristalsis in real-time. Using these ultrasonic criteria, the infants studied were assessed as 112 with IHPS and 88 normals. All the infants were followed up, and the method was 100% accurate, with no false positive or negative results. The statistics of the static measurements are included and show that the canal length is the only precise discriminator between a normal and an hypertrophied pylorus. The method is accurate, rapid and safe, allowing earlier diagnosis of IHPS. It should replace the barium meal in the evaluation of IHPS where the clinical diagnosis is in doubt.

Female↗
PubMed1992

Pyloric stenosis in a premature infant.

Workup of a case of hypertrophic pyloric stenosis in a premature infant showed absence of ultrasonic criteria for diagnosis. Transpyloric intubation for enteral feeding may delay the diagnosis of this disorder and has been thought to play a role in its development.

Humans↗
PubMed1987

Pyloric stenosis--a timed perspective.

In a review of 90 infants with pyloric stenosis who underwent pyloromyotomy, preoperative nasogastric drainage for more than six hours during the period of fluid resuscitation accompanied by a period of postoperative drainage for more than 12 hours resulted in better acceptance of a graduated feeding protocol with fewer emesis, earlier completion of full feeding, and shortened hospital stay.

Female↗
PubMed1989

The significance of alkalosis and hypochloremia in hypertrophic pyloric stenosis.

Hypochloremic alkalosis is the "classical" electrolyte abnormality seen in hypertrophic pyloric stenosis (HPS), yet it occurs in only about half the patients. To define the clinical differences between infants who were alkalotic or hypochloremic and those who were not, we reviewed the records of 216 patients treated for HPS over a recent 5-year period at our institution. The 202 patients who had a full set of serum electrolytes drawn on admission were divided into nonalkalotic and alkalotic bicarbonate groups A (less than or equal to 25 mEq/L, n = 105) and B (greater than 25 mEq/L, n = 97) and also nonhypochloremic and hypochloremic chloride groups A (greater than or equal to 99 mEq/L, n = 117) and B (less than 99 mEq/L, n = 85). The alkalotic group B had a significantly higher proportion of black patients (17.5% v 8%), longer mean duration of illness (17.8 v 9.4 days), higher incidence of palpable pyloric mass (97% v 82%), greater degree of dehydration, lower mean serum sodium (136.3 v 137.7 mEq/L), lower mean serum potassium (4.50 v 5.15 mEq/L), and lower mean serum chloride (92.4 v 102.3 mEq/L) than did the nonalkalotic group A.(ABSTRACT TRUNCATED AT 250 WORDS)

Alkalosis↗
PubMed2001

Pyloric stenosis: new histopathologic perspective using confocal laser scanning.

BACKGROUND/PURPOSE: Idiopathic hypertrophic pyloric stenosis (IHPS) is a common infantile disorder characterized by enlargement of the pylorus and gastric outlet obstruction. Its complete etiology is still not fully understood, but recent research has focussed on abnormalities of nerve distribution. The authors used confocal laser scanning microscopy to perform 3-dimensional studies of pylorus biopsy specimens taken from cases of IHPS and present their findings. METHODS: Pylorus biopsy specimens obtained at pyloromyotomy from 6 infants with IHPS were studied using confocal microscopy and compared with 6 control pylorus biopsy specimens from patients without gastrointestinal disease. Biopsy specimens were pretreated to enhance nerve expression by using protein gene product 9.5 (PGP9.5) polyclonal antibody to identify enteric nerve system fibers. Double staining immunofluorescence was used to detect alpha smooth muscle actin (SMA), a smooth muscle marker. RESULTS: Control pylorus biopsy specimens showed many thin PGP9.5-positive nerve fibers in the circular and longitudinal muscle layers that communicated with each other to create a 3-dimensional meshlike network. Muscle cells stained by alpha SMA antibody were thin. In contrast, muscle cells from IHPS patients were fat and round. The PGP9.5 staining nerve fibers from IHPS patients formed numerous, thick, and contorted bundles that did not communicate. CONCLUSIONS: By using confocal laser microscopy the authors were able to identify abnormally thick contorted nerve bundles in the pyloric muscle layers of infants with IHPS. These anormal nerve bundles have not been described previously because of the limitations of 2-dimensional microscopy. The authors suspect that the etiology of IHPS may be related to these abnormal fibers.

Biopsy, Needle↗
PubMed1997

Infantile hypertrophic pyloric stenosis and achalasia: NO-related or non-related conditions?

BACKGROUND: The regulated ability of sphincters to relax allows adequate control of digestive transit. Relaxation of the lower esophageal sphincter (LES) is essential for esophageal emptying and, similarly, pyloric relaxation permits gastric emptying. When the relaxatory response of these sphincters is impaired, luminal transit is altered, as occurs in achalasia and hypertrophic pyloric stenosis. Nitric oxide (NO) has been identified as the main inhibitory neurotransmitter in both sphincteric regions. Moreover, the absence of NO synthase in the LES and the pylorus has been implicated in the pathogenesis of infantile hypertrophic pyloric stenosis (IHPS) and achalasia, respectively. CASE REPORT: We present the case of a 12-year-old boy diagnosed with these two different conditions attributed to NO absence: IHPS and achalasia. CONCLUSION: To our knowledge this is the first time that such an association has been reported. Whether IHPS and achalasia have been associated in this patient by chance or because they share common pathophysiological mechanisms remains speculative, but is a tantalizing dilemma.

Abnormalities, Multiple↗
PubMed1986

Influence of age, sex, duration of symptoms and dehydration of serum electrolytes in hypertrophic pyloric stenosis.

A review was conducted of 234 consecutive patients with hypertrophic pyloric stenosis (HPS) proven at operation. The relationship of age, sex, the duration of symptoms and the clinical degree of dehydration to the severity of metabolic derangement as reflected by alterations in serum electrolytes and acid-base status, was analysed statistically. The length of history and the degree of dehydration was found to have predictive value in identifying those likely to have major metabolic disturbances. Where severe vomiting has persisted for more than 1 week, major derangements of the biochemical parameters should be anticipated; and where clinical assessment of dehydration is estimated as being greater than 5%, there is almost always some major biochemical abnormality present. Nevertheless, variation in individual cases necessitates that all patients with suspected HPS should have serum electrolytes and acid-base estimations performed.

Age Factors↗
PubMed1992

[Study on 27 surgical cases of hypertrophic pyloric stenosis at Kyoto City Hospital].

Twenty-seven patients of hypertrophic pyloric stenosis operated on at our hospital between 1977 and 1991 were reviewed. The patients consisted of 22 boys and 5 girls, with males accounting for 81%. Seventeen of the 27 patients were the first children of their mothers. Vomiting was first noted between 10 and 58 days after birth with a mean of 26.5 days, and neonatal onset was observed in 67% of all patients. The body weight decreased after the onset in 17 patients, including 1 in which it decreased below the birth weight. Hypochloremia was the most frequent preoperative electrolyte imbalance, being observed in 41% of all patients. Alkalosis was noted in 17 of the 22 patients in which arterial blood gas analysis could be performed. The olive was palpated preoperatively in 24 (89%) of the 27 patients. The body weight increased in all patients after operation, and the mean daily increase was 26.7 g. The mean period of hospitalization after operation was relatively short at 8.3 days. Postoperative vomiting was observed in 16 patients (59%), with its mean duration being 26 days. All patients showed normal growth after operation, and no postoperative complications were noted.

Female↗
PubMed1993

An analysis of feeding regimens after pyloromyotomy for hypertrophic pyloric stenosis.

We retrospectively reviewed 223 infants who underwent pyloromyotomy for hypertrophic pyloric stenosis (HPS) at our institution from January 1984 to May 1990. Each patient's postoperative feeding regimen was determined by the attending surgeon. The four distinct regimens used were as follows: A (n = 66): NPO overnight (> 10 h) with cautious feeding advancement every 4 hours x 2, then every 2 hours x 2, then every 1 1/2 hours x 8, then ad lib; B (n = 46): NPO until 6 to 8 hours postoperatively with the same cautious feeding advancement as in A; C (n = 42): NPO until 6 hours postoperatively with accelerated feeding advancement every 2 hours x 8, then ad lib; D (n = 69): NPO until 6 hours postoperatively with accelerated feeding advancement every 1 hour x 12, then ad lib. There were no significant differences in age at diagnosis or degree of dehydration among groups. From group A to group D, there was a progressive increase in amount and incidence of postoperative vomiting, both after the first three feedings and in the total postoperative period. However, patients in groups C and D had a shorter postoperative hospital stay and lower charges than did patients in groups A and B. Following discharge, no patient was readmitted for vomiting or dehydration. We conclude that feedings started 6 hours after pyloromyotomy for HPS with accelerated feeding advancement every 2 hours increases the incidence and frequency of postoperative vomiting, but not unacceptably, and results in a significantly shorter postoperative stay.

Analysis of Variance↗
PubMed1990

[Sonography of hypertrophic pyloric stenosis--attempt at prognostic evaluation based on sonographic criteria].

Clinical and sonographic findings in 27 patients were analysed in a retrospective study in order to find sonographic criteria for the necessity of surgical treatment of infantile hypertrophic pyloric stenosis. Thirteen patients underwent surgical treatment, 14 were cured by conservative management only. Patients did not differ as regards clinical or serological findings when first investigated by means of sonography. On first examination, carried out about three days after the onset of symptoms, most of the patients who necessitated surgical treatment showed 1) a long canal segestorius (greater than 20 mm), 2) a significantly elevated muscle to lumen ratio exceeding 2:1, 3) pathological "target sign" in the medium upper stomach measuring more than 18 mm, 4) no passage of stomach contents to the duodenum on real time sonography examination. However, this constellation of features was also observed in some patients who were treated successfully by conservative management. Thus, although statistically significant differences were found between these two groups of patients, a definitive prospective decision in the individual patient with regard to the necessity of surgical treatment could not be obtained on the basis of the above-mentioned ultrasound signs. Our study suggests that sonographic criteria are helpful in establishing the diagnosis of infantile hypertrophic pyloric stenosis and also in evaluation of the response to therapeutic management, but--at the time of initial investigation--cannot provide accurate prognostic information.

Gastric Emptying↗
PubMed1990

The Indian experience with hypertrophic pyloric stenosis.

A study of 58 consecutive Indian infants operated for congenital hypertrophic pyloric stenosis revealed an accentuated male predominance in the incidence of the disease and far less preoperative hemetemesis as compared to that in their Western counterparts. 'Pyloric tumor' was palpable in 89% of cases. Only 34.5% of these infants were first born. Postoperative vomiting occurred in 13.8% of patients and wound sepsis was not encountered. Air contrast radiography confirmed the diagnosis in clinically doubtful cases.

Female↗