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At least 361 records · Page 20Linked to original sources
PubMed2002

Pneumatosis cystoides intestinalis associated with ascites and pyloric stenosis secondary to a chronic duodenal ulcer: case report.

A thirty eight year old female with a long standing history of a chronic duodenal ulcer presented at the Nyeri Provincial General Hospital with vomiting, abdominal pain and abdominal distension. Oesophago-gastro-duodenoscopy revealed a tight pyloric stenosis while abdominal ultrasonography showed ascites. At laparatomy, she was coincidentally found to have pneumatosis cystoides intestinalis (PCI). The recent literature is reviewed and this case of PCI associated with ascites and pyloric stenosis secondary to a chronic duodenal ulcer is reported.

Abdomen↗
PubMed1999

Analysis of gastrointestinal sounds in infants with pyloric stenosis before and after pyloromyotomy.

BACKGROUND: Although recent advances in computer technology enable us to analyze gastrointestinal sounds data objectively with ease, this clinical application has been investigated in only a few disorders. To investigate one potential role of this approach in pediatric practice, we recorded and analyzed gastrointestinal sounds in infants with hypertrophic pyloric stenosis (HPS), a motility-related disorder that is common in children. METHODS: In 15 infants with pyloric stenosis, gastrointestinal sounds were collected with a microphone placed 3 cm below the umbilicus for 60 minutes before pyloromyotomy and at 9 to 12 hours, 20 to 24 hours, 40 to 48 hours, and 112 to 120 hours after the operation. Data were entered into a computer to sum the amplitude of sound signals as a sound index (SI; mV per minute). In 12 infants, gastric emptying was measured immediately before each sound recording, using a marker dilution-double sampling method. RESULTS: Before surgery, the mean SI was 4.6 +/- 1.0 mV per minute, significantly less than in healthy controls (31.7 +/- 8.4 mV per minute). The SI remained in a similar range until 12 hours after operation, after which it began increasing to reach the normal range by 48 hours after operation (30. 0 +/- 9.4 mV per minute). Gastric emptying, also low in HPS before pyloromyotomy, increased by 4 to 5 times after surgery. There was a significant positive correlation between SI and gastric emptying. The incidence of postoperative symptoms (such as vomiting) were correlated significantly with SI at 24 hours after surgery. CONCLUSION: This study found decreased gastrointestinal sounds to be among physical findings suggestive of HPS and a useful indicator of gastric emptying and bowel motility after pyloromyotomy. Computer-assisted analysis of gastrointestinal sounds might be helpful in clinical practice for pediatric patients with some gastrointestinal disorders.

Analysis of Variance↗
PubMed1977

[Surgical attitude in pre-pyloric stenosis due to corrosive substances. Intravascular segmental antrectomy in Y-V. Report of 80 cases (author's transl)].

The author reports 80 cases of gastric stenosis due to caustic substances, of which 20 were limited only to the stomach and 60 were accompanied by esophageal stenosis. In most cases (78.8 p. cent), the site of the gastric stenosis was antral, pre-pyloric and the duration of onset was, on average, 3 weeks. Surgical treatment depended on the extent of the corrosive lesions. In limited antral stenosis, we carried out antrectomy with gastroduodenal anastomosis. In pre-pyloric stenosis situated 3 to 5 cm from the pylorus, the author recommends conservation of the non-functioning pylorus by double pylorotomy and anastomosis with the whole of the border of the stomach, describing a personal procedure named intravascular Y-V segmental antrectomy. The criterion which decides the proximal border of the resection, should be the appearance of the gastric mucosa, the section should pass immediately above the caustic ulceration. In extensive gastric stenosis (more than 75 p. cent) of the stomach and in evolutive corrosive lesions, we recommend Y-shaped jejunostomy, of Maydl type. In post-caustic pre-pyloric stenosis we operated on 76 cases out of 80 with 3 deaths (3.9 p. cent mortality). In 25 patients we carried out esophagoplasty about 6 months after the accident. We preferred restrosternal isoperistaltic coloesophagoplasty by Kelling's procedure. To increase the circulation through the left colic artery and marginal artery, we ligatured the middle colic artery and right colic artery at the same time as the gastrostomy.

Adult↗
PubMed1999

Diagnosing hypertrophic pyloric stenosis: does size matter?

This retrospective study examines the size of the pyloric tumour at the time of surgery in 100 patients (76 boys, 24 girls) operated over a 2.75 years period from June 1993 to March 1996. The size of the pyloric tumour was classified into one of three categories (short, moderate or large) by the operating consultant and documented in the operation note. This study supports the view that the pyloric tumour increases in size with the progressing age of a baby. Nowadays the diagnosis of hypertrophic pyloric stenosis (HPS) is made on average 2 weeks earlier than in a similar study 4 decades ago. Two thirds of the patients in the subgroup with short- and moderate-size pyloric tumours did not require any imaging technique to arrive at the diagnosis. Unexpectedly a more frequent use of imaging techniques was required in the subgroup of large pyloric tumours; large tumours tend to present as an ill-defined fullness in the right upper quadrant rather than a distinct olive.

Algorithms↗
PubMed1997

Germ cell cancers in adult males are associated with a history of infantile pyloric stenosis.

Germ cell cancers (GCT) are the most common cancers of young men and are curable in at least 90% of cases. A number of aetiological factors have been identified which predispose to the development of these cancers, such as cryptorchidism and hernia. We report the association of GCT with infantile pyloric stenosis (IPS). The case records from 542 adult males with germ cell cancer arising from any site were screened for a history of pyloric stenosis requiring surgical treatment. Nine cases were observed (expected number = 2.168; chi squared = 21.5 (P < 0.001), standardised ratio = 4.15; 95% confidence interval 1.9-7.88). The recognition of rare associations of germ cell tumours may lead to the identification of genetic and environmental factors involved in their aetiology.

Adolescent↗
PubMed1981

Conservative management of infantile pyloric stenosis by nasoduodenal feeding.

Fifty cases of infantile plyoric stenosis were treated conservatively by transpyloric nasoduodenal tube feeding. The mean age on admission was 38.2 days. Transpyloric intubation was carried out in all patients and 45 (90%) with infantile pyloric stenosis were cured by nasuduodenal feeding. Among 5 (10%) requiring surgical intervention, abandonment of nasoduodenal feeding was the cause in only 3, and the parents chose an operation in the remaining 2 a few days after nasoduodenal feeding had been started. In non-surgically cured cases (45), mean body weights on admission and at discharge were 3,750 g and 5,177 g respectively; the duration of nasoduodenal feeding was 8 to 37 days (mean 17.2 days), mean weight gain during nasoduodenal feeding was 42.7 g/day and mean hospital stay was 39.7 days (38.0 days in 43 cases without any associated disorder). This experience suggests that nasoduodenal feeding in this report is a more effective treatment for infantile pyloric stenosis than any traditional medical treatment and it could be the preferred management in the small group of patients for whom an operation could carry a high risk, or whose parents refuse operation.

Body Weight↗
PubMedDate not supplied

Clinical and demographic aspects of congenital pyloric stenosis in Israel.

A survey was made of 292 infants with congenital pyloric stenosis, diagnosed between 1967 and 1977 in seven hospitals in Israel. The incidence of the condition was estimated as 0.05 per 100 livebirths, and was higher among males, especially firstborn males. The incidence was higher among Oriental Jews than was thought, although the prevalence was higher among Ashkenazic Jews. The features of projectile vomiting, a pyloric olive and visible peristalsis were studied and their clinical and diagnostic significance was compared with that of radiological investigations. Concomitant anomalies and postoperative complications found in this series are presented. The efficacy of surgical treatment is emphasized.

Birth Order↗
PubMed2001

Antenatal prediction of hypertrophic pyloric stenosis.

This is the first reported case where the diagnosis of hypertrophic pyloric stenosis (HPS) was entertained in the antenatal period and the neonate was followed up in the postnatal period on a prospective basis until the HPS became manifest.

Adult↗
PubMed1989

Hypertrophic pyloric stenosis in the adult.

In view of the low incidence of hypertrophic pyloric stenosis, we present a case of this pathology in a male aged 74. Stenosis was of the diffuse type, associated with gastric ulcer and chronic atrophic gastritis. The patient was admitted to our Service with upper digestive tract hemorrhage after deterioration of the ulcer.

Aged↗
PubMed1983

The ultrasonic features of hypertrophic pyloric stenosis, with emphasis on the postoperative appearance.

Six patients were examined with high-resolution real-time ultrasound following Rammstedt pyloromyotomy for hypertrophic pyloric stenosis. At surgery, the pyloric muscle thickness was greater than or equal to 4 mm, diameter greater than or equal to 13 mm, and length greater than or equal to 19 mm. Sequential sonograms showed that all three measurements fell to normal levels within 6 weeks.

Female↗
PubMedDate not supplied

Corrosive pyloric stenosis--a report of two cases.

Two unusual cases of post corrosive pyloric stenosis in adults are reported. Both the cases were diagnosed clinically and confirmed by barium meal examination. Patients were discharged following anterior gastrojejunostomy. Follow-up examination did not reveal any problem. However, both of them are undergoing regular dilatation for the associated oesophageal stricture.

Adult↗
PubMed1989

Prostaglandin E2 in pyloric stenosis.

Prostaglandins are presumed to have many cytoprotective properties that play a role in the pathogenesis of duodenal ulcer and its complications where decreased levels of prostaglandin E2 (PGE2) impair gastric motility, oppose ionic membrane influx, and enhance obstructive changes. These are just some of the mechanisms that may cause pyloric obstruction and may result from decreased PGE2 levels. To evaluate this hypothesis, 17 patients with duodenal ulcer complicated by pyloric stenosis were examined. Biopsy specimens were obtained from the duodenal bulb, ulcer margins, gastric antrum, fundus, and gastric secretions. Prostaglandin E2 levels were measured and compared with those taken from the same areas during a second endoscopy in a later quiescent or exacerbated phase. During the active phase of pyloric stenosis, decreased levels of PGE2 were found in the gastroduodenal tissues and secretions were compared with levels found during convalescence. These level differences were statistically significant. A correlation between the severity of the clinical and endoscopic findings and the PGE2 levels was found. A further decrease in PGE2 levels in the second endoscopy were indicative of the presence of scar tissue, representing an irreversible obstructive peptic disease.

Aged↗
PubMed1975

Congenital hypertrophic pyloric stenosis. Surgical experience.

Of 132 infants who underwent surgery for congenital hypertrophic pyloric stenosis during a 13-year period, 83% were males and 31% were firstborn males. Ninety-one percent of the patients presented with projctile vomiting after feeding, and an "olive" was palpated in 92%. Upper gastrointestinal studies were not obtained in 73%. Twenty patients had positive family histories. For the entire 13 years under review, the average total hospital was 6.14 days, and the average postoperative stay was 4.45 days. For the later period 1970 to 1974, the hospital stay was 5.2 and 3.7 days, respectively. Intravenous fluids were not used in 77% of the patients and were used but not needed from a surgical standpoint in 9%. No deaths resulted from the procedure for pyloric steonsis, but there were five complications. Only 13 patients had no vomiting after operaion, whereas 105 (79%) had modest regurgitation of mild vomiting. Specific preoperative, operative, and postoperative care is important in every case.

Congenital Abnormalities↗
PubMed1994

Prostaglandin-induced foveolar hyperplasia simulating pyloric stenosis in an infant with cyanotic heart disease.

Prostaglandin infusion is used to maintain patency of the ductus arteriosus in infants with cyanotic congenital heart disease. Recently, gastric outlet obstruction as a result of prostaglandin infusion has been described. In our case, an upper gastrointestinal contrast study seemed to depict the typical appearance of pyloric stenosis in an infant who had received an infusion of prostaglandin for a prolonged period. Serial ultrasonograms, however, disclosed progressive elongation of the antropyloric channel without wall thickening. This report is the second to illustrate prostaglandin-induced gastric outlet obstruction in a vomiting infant with a gastrointestinal series diagnosis of pyloric stenosis.

Diagnosis, Differential↗
PubMed1991

Investigation and diagnosis of hypertrophic pyloric stenosis.

Forty-nine infants who underwent investigation or surgery for hypertrophic pyloric stenosis (HPS) over a 30-month period were reviewed. Significant weight loss was present in 18 infants, of whom 16 had HPS. A test feed was performed in 46 infants with 1 of 27 false positive and 6 of 29 false negatives. An ultrasound examination was performed in 34 infants with 4 of 23 false positives and 1 of 11 false negatives. It is recommended that if the test feed is positive then surgery should be performed, otherwise an ultrasound examination can be used as a screening test but a positive result should be confirmed by other means before surgery.

False Negative Reactions↗