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At least 37 records · Page 2Linked to original sources
PubMed2004

A dilated fetal stomach predicts a complicated postnatal course in cases of prenatally diagnosed gastroschisis.

OBJECTIVE: The purpose of this study was to determine whether dilation of the fetal stomach is associated with increased perinatal complications in infants with prenatally diagnosed gastroschisis. STUDY DESIGN: From 34 newborn infants with gastroschisis who were delivered at our institution over a 10-year period, 2 groups were analyzed on the basis of the presence or absence of a dilated fetal stomach. Reactive versus nonreactive nonstress test results were recorded, when performed. Neonatal outcomes were compared. RESULTS: Twenty-one fetuses had no evidence of gastric dilation. Thirteen fetuses had a dilated fetal stomach that was identified by ultrasound scanning. Within this group there was a higher incidence of nonreactive nonstress tests (P=.01). Infants with a prenatally dilated stomach had a higher incidence of volvulus and neonatal death, a significantly delayed time to full oral feeds, and a longer hospitalization than those infants who did not have a prenatally dilated stomach (P <or=.05). CONCLUSION: Postnatal morbidity and mortality rates are increased in infants with gastroschisis who have a prenatally dilated stomach. These fetuses, although not acidotic at delivery, also had a higher incidence of nonreactive nonstress test results.

Adult↗
PubMed1996

Clinics in diagnostic imaging (13). Congenital duodenal obstruction.

A newborn Chinese baby boy presented with repeated bile-stained vomiting. Plain radiograph showed a "double-bubble" shadow. Upper gastrointestinal series demonstrated, in addition to a dilated stomach, rounded dilatation of the second part of duodenum with partial obstruction. At operation, a diaphragm was found at duodenotomy over the waist of the proximal duodenal constriction. Excision of the diaphragm and transverse closure of the duodenotomy produced relief of the obstruction. The role of imaging and the surgical approach to duodenal diaphragm are discussed.

Diagnosis, Differential↗
PubMed2005

Late-onset primary gastric outlet obstruction--an unusual cause of growth retardation.

We describe our experience of 2 children and review 6 previously reported cases of late-onset primary gastric outlet obstruction. The patients presented with abdominal pain, recurrent nonbilious vomiting, and growth retardation after a variable period of normal food intake. There was no history of peptic ulceration and corrosive ingestion. Barium meal showed dilated stomach with delayed gastric emptying. Exploration demonstrated dilated stomach with no intrinsic or extrinsic mechanical obstruction at the pylorus. Heineke-Mikulicz pyloroplasty was curative. Patients improved postoperatively and started thriving. We propose etiology and the term pyloric achalasia for this late-onset functional gastric outlet obstruction.

Abdominal Pain↗
PubMed1991

[Anesthesia in the patient with stomach dilatation-volvulus].

Before a decision on the anesthetic protocol and the various patient support measures can be taken, the pathophysiological changes that occur during a gastric dilatation-volvulus need to be evaluated. The most important changes are of a circulatory and/or respiratory nature, inducing hypotension, hypovolaemia, cardiac dysrhythmias, a decreased respiratory minute volume, and subsequently resulting in changes in the acid-base balance and plasma electrolyte concentration. In view of these changes and the increased anaesthetic risk for the patient with gastric dilatation-volvulus, the use of barbiturates or ketamine cannot be recommended for anaesthetising these patients. With the use of neurolept-analgesic combinations, such as methadone-droperidol or sufentanil-midazolam, an increased cardiovascular stability and an ample analgesic effect can be obtained. Especially with the potent sufentanil in combination with midazolam, an excellent anaesthesia for patients with gastric dilatation-volvulus can be achieved.

Anesthesia↗
PubMed1991

[Stomach dilatation-volvulus in the dog: current viewpoint and retrospective study in 160 patients].

Diagnosis and treatment of gastric dilatation-volvulus syndrome in the dog are described. A comparison of results obtained between 1984 and 1990 with results from 1977 to 1982 shows a significant decrease in mortality from 63% to 29%, and in the recurrence rate from 82% to 15%. Mortality in patients in which the stomach was decompressed before referral did not differ from that in patients in which decompression was not performed. Two methods of fixation of the pyloric antrum to the abdominal wall are compared. Complications and recurrence rates after tube gastrostomy do not differ significantly from those after gastropexy. The common opinion that dilatation precedes volvulus is rejected. A new hypothesis is proposed, in which volvulus precedes dilatation.

Algorithms↗
PubMed2004

A case of acquired gastric outlet obstruction diagnosed at 16 years of age.

A 16-year-old boy was admitted with an 8-year history of abdominal pain, vomiting, and growth retardation. There was no history of peptic ulcer or caustic ingestion. He was severely cachexic, and barium meal showed a dilated stomach with delayed gastric emptying time and no contrast in the duodenum afterward. Exploratory laparotomy demonstrated a grossly dilated stomach with a smooth wall and a stenotic ring at the pylorus but without any muscular hypertrophy. There was no extrinsic compression of the pylorus or any scarring near it. Heineke-Mikulicz' pyloroplasty was performed. Histopathological examination of the pylorus showed normal cellular pattern without any neoplastic or inflammatory cells. The patient improved postoperatively and gained 8 kg in the first month following the operation.

Adolescent↗
PubMed2006

[Traumatic diaphragmatic hernia presenting with shock 1 year after blunt injury; report of a case].

A 62-year-old male who had had the left femoral neck fracture due to a traffic accident 1 year earlier was admitted to our hospital because of abdominal pain. He was diagnosed with a left traumatic diaphragmatic hernia due to the previous traffic accident; his condition was also complicated by shock because the mediastinum was compressed by his severely dilated stomach. We performed an emergent operation. A thoracotomy revealed a large defect, about 5 cm in size, at the central tendon of the left diaphragm and a severely dilated stomach in the left thoracic cavity. The ruptured diaphragm was closed directly after reduction of the stomach.

Accidents, Traffic↗