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Results for “PYLOROSPASM”

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At least 91 records · Page 5Linked to original sources

PubMed2004

Real time high resolution magnetic resonance imaging for the assessment of gastric motility disorders.

BACKGROUND: The aim of this study was to evaluate whether patients with increased or decreased gastric motility can be differentiated from healthy volunteers by means of real time magnetic resonance imaging (MRI). PATIENTS AND METHODS: Ten healthy volunteers, 10 patients with gastroparesis, and 10 patients with functional pylorospasm/peptic pyloric stenosis underwent real time MRI. All patients were examined on two separate days; once prior to therapy and once after adequate therapy. Antral motility was quantified by calculating the gastric motility index. RESULTS: Patients with gastroparesis showed a lower motility index compared with the reference volunteer group while the mean motility index of the patient group with pylorospasm was more than three times higher than that of the reference value of the volunteer group. However, the gastric motility index in the patient group with gastroparesis increased, and in the group with functional pylorospasm/peptic pyloric stenosis it decreased significantly after therapy. CONCLUSION: Real time MRI is a reliable tool for assessment of gastric motion. Furthermore, differences in gastric motility index in patients with increased or decreased gastric motility could be evaluated and quantified. Due to the non-invasive character of MRI, this imaging modality may be an attractive alternative to conventional invasive diagnostic tools for gastric motility disorders and therapeutic monitoring.

Adult↗

PubMed1975

"Burned-out" pyloric stenosis: an elusive gastric outlet obstruction.

Four cases of infantile pyloric stenosis are presented to illustrate the difficulties found in diagnosing pyloric stenosis. Clinical, histological, surgical, and roentgenologic examination must be combined to determine the optimum treatment. All patients exhibited failure to thrive and gain weight normally, but few showed palpable tumors upon abdominal examination. The results of upper gastrointestinal examination are often more confusing than helpful, but previously performed Gl studies have been rewarding. The main problem is to rule out pylorospasm, and a trial of treatment with antispasmodics is essential. The presence or absence of a residual muscle mass at surgery would call for pylorotomy or pyroplasty, respectively.

Female↗

PubMed1994

Hypertrophic pyloric stenosis in the infant without a palpable olive: accuracy of sonographic diagnosis.

PURPOSE: To evaluate the accuracy of sonography for both diagnosis and exclusion of pyloric stenosis in the infant with nonbilious vomiting without a palpable olive and to clarify the relationship between infant age and size and the dimensions of the hypertrophic pylorus. MATERIALS AND METHODS: The sonograms of 152 infants with suspected pyloric stenosis were evaluated. The prospective diagnoses were categorized as pyloric stenosis, normal pylorus, and pylorospasm with potential to progress to pyloric stenosis. Positive findings were confirmed at surgery; negative findings were confirmed by means of chart review. RESULTS: Sensitivity, specificity, and accuracy of sonography in determination of appropriate surgical referral were 100%. A significant (P < .05) correlation was found between the size of the hypertrophied muscle and the age of the patient at initial examination. CONCLUSION: Sonography is highly sensitive and, in this patient population, highly specific, and by virtue of direct visualization of the pyloric muscle, it is the method of choice for both diagnosis and exclusion of pyloric stenosis.

Humans↗

PubMedDate not supplied

Gastric retention of enteric-coated magnesium chloride tablets.

OBJECTIVE: To describe a patient with gastric retention of enteric-coated magnesium chloride tablets. Potential drug and disease etiologies accounting for failure to empty this dosage form are discussed. DESIGN: Single case report. CASE SUMMARY: A seriously ill patient with metastatic small-cell lung cancer accumulated 21 enteric-coated magnesium chloride tablets in his stomach during a four-day administration period. The patient had gastroscopic evidence of mild pylorospasm and suspected gastric motor dysfunction. The latter may have been the result of several factors including concurrent use of oxycodone, vagal dysfunction from chronic alcoholism and cisplatin-based chemotherapy, and possibly a paraneoplastic neuromuscular syndrome involving the gastrointestinal tract. CONCLUSIONS: Enteric-coated tablets are indigestible solids, often of considerable size. Strong antral contractions, associated with phase 3 of the interdigestive migrating myoelectric complex, are usually required to carry such dosage forms through a normal pyloric channel and into the duodenum. Seriously ill patients who may have gastric hypomotility or pyloric channel narrowing are probably not good candidates for therapy with large enteric-coated dosage forms.

Aged↗

PubMed2004

Delayed salicylate toxicity at 35 hours without early manifestations following a single salicylate ingestion.

OBJECTIVE: To report a case of delayed toxicity following a single ingestion of aspirin, where the initial concentrations were nearly undetectable and the patient was completely asymptomatic for the first 35 hours. CASE SUMMARY: A 14-year-old white female was evaluated after a single ingestion of 120 tablets of aspirin 81 mg/tablet hours before arrival to the emergency department. She denied nausea, abdominal pain, tinnitus, or shortness of breath. She received one dose of activated charcoal. The first salicylate concentration (4 h after ingestion) was 1 mg/dL. At 35 hours, the patient became symptomatic (dizziness, tinnitus, epigastric discomfort). Her salicylate concentration at that time was 46 mg/dL. A second dose of activated charcoal was administered, and intravenous bicarbonate with potassium was started as a continuous infusion for 30 hours. DISCUSSION: While delayed salicylate toxicity is well reported in the literature, no report was found regarding concentrations increasing to toxicity 35 hours after ingestion. The delayed aspirin absorption may be due to salicylate-induced pylorospasm or the formation of pharmacobezoars. CONCLUSIONS: In cases with known salicylate ingestion, it is important to follow salicylate concentrations every 4 hours until they are steadily decreasing according to a 4-hour half-life and the patient shows no symptoms of salicylate intoxication.

Adolescent↗

PubMed1982

Radiographic abnormalities after gastric bypass.

Postoperative radiographic findings in the gastrointestinal tract were analyzed in 43 of 72 patients with gastric bypass for morbid obesity. In 15 patients studied because of early postoperative vomiting or abdominal pain, two showed leak from the proximal gastric pouch and six showed impairment of proximal pouch emptying at the anastomosis or proximal efferent loop. In four of the six, the impaired emptying was due to transient postoperative edema and improved spontaneously. Three patients had impairment of distal gastric pouch emptying due to pylorospasm. Five patients studied in the late postoperative period showed dehiscence of the gastric staple line, which can be difficult to demonstrate radiographically. Familiarity with the normal and the abnormal radiographic appearance after gastric bypass is important in elucidating the nature of the problems that can arise after this operation.

Digestive System↗

PubMed1999

[Suprapyloric resection of stomach in patients with ulcer disease].

Suprapyloric transversal resection of the stomach is one of relatively sparing methods of surgical treatment for ulcerative disease. In Medical Centre of "VAZ", suprapyloric resection of the stomach was carried out as a method of treatment of gastric ulcer in 181 patients (study group) and 139 patients underwent resection 2/3 of the stomach by Billroth-1 (control group). The ulcer located in cardial and mediogastric regions (1 type by Johnson). Among the patients of study group postoperative lethality made up 1.1%. Follow-up results of operative treatment was quite favourable in 96.3% of cases and unsatisfactory--in 3.7% (persistent pylorospasm). In control group follow-up results of surgical treatment in 86.4% were appraised as excellent and good, in 13.6%--satisfactory due to postoperative development of damping-syndrome. Comparison of results of follow-up examination in two groups of operated patients has evidenced of the best functional results after performance of suprapyloric resection of the stomach.

Adult↗

PubMed2000

Thoracoscopic truncal vagotomy.

BACKGROUND: Nowadays the only indications to truncal vagotomy is recurrent ulceration after previous gastric surgery. Truncal vagotomy allows us to obtain a reduction in acid production and to promote ulcer healing, but this technique causes pylorospasm in about 20% of cases and this requires further synchronous or metachronous pyloric drainage procedure. For this reason, videothoracoscopic truncal vagotomy is reserved to patients with gastroresection. METHODS: The authors describe 15 patients treated with videothoracoscopic truncal vagotomy. In 12 patients, a gastrojejunostomy was done according to Roux technique in 2 patients, a reconstruction according Billroth II technique and in 1 patient, a gastroduodenostomy according to Billroth I technique. RESULTS: Videothoracoscopic bilateral truncal vagotomy was done in all patients; operation time was 45 minutes. During the postoperative period there were no complications. No patients underwent medical therapy for peptic ulcer. Only in 12 patients was it possible to execute an endoscopic follow-up in a period of 3 to 4 years. In all patients the ulcer was completely healed. CONCLUSIONS: Complete vagotomy in patients who present with recurrent gastrointestinal bleeding after previous gastroresection, is associated with significant risks. Videothoracoscopic bilateral truncal vagotomy as a simple and efficient procedure seems to be an alternative treatment for the management of recurrent ulceration after previous gastric surgery for peptic disease.

Aged↗

PubMed1999

[Omentoplasty in surgical management of postpulmonectomy pleural empyema].

A method of treating postpulmonectomy pleural empyema, practically implemented in this country for the first time, is described. Three patients are subjected to operation. Right pulmonectomy for lung cancer and chronic inflammatory process is done twice, and left pleuropulmonectomy for tuberculosis--once. Postpulmonectomy empyema persists in all three cases regardless of the adequate continuous suction drainage and intrapleural antiseptic management. Anaerobic and gram-negative flora is isolated. The size and location of the intrapleural cavity being cured are assayed by CT, thoracic ultrasonography and fistulography. In none of the patients is clinical and FBS evidence of bronchopleural fistula established. The operative procedure consists in resection of a 4 cm segment from the underlying rib in the drainage zone, and further cavity treatment under thorascopic control. Minor median laparotomy and skeletization of the greater omentum are performed preserving a major nutrient vessel depending on the location of the cavity. The omentum is drived into the pleural cavity through a parietal opening of the diaphragm, measuring 3-4 fingerbreadths. Pleural cavity drainage is carried out according to Redon. Two patients run an uneventful postoperative course. One female patient develops pylorospasm successfully cured by spasmolytic therapy and H2 blockers. CT and thoracic echography do not show presence of residual cavities. The patients are free of any complaints over periods ranging from 6 to 16 months postoperatively. The inference is reached that omentoplasty is a new method promoting successful elimination of both postpulmonectomy empyema, and other residual pleural cavities as well, with or without bronchopleural fistula.

Adult↗

PubMed2001

Gastrin, somatostatin and infantile hypertrophic pyloric stenosis.

UNLABELLED: Despite multiple and often contradictory research, no firm conclusions regarding the role of hypergastrinaemia in infantile hypertrophic pyloric stenosis (IHPS) have been established. Evaluation of somatostatin, the main physiological antagonist of gastrin, has not been assessed in previous studies. Long-term evaluation following pyloromyotomy suggests persistent abnormalities in gastrin and somatostatin in IHPS. The objective of this case-controlled study was to compare fasting serum gastrin and somatostatin levels in IHPS. Serum sample were collected from 39 children with IHPS at the time of pyloromyotomy and 20 age-matched controls with no evidence of gastrointestinal disease. Standard radioimmunoassay techniques were used to detect circulating levels of the hormones. A two-tailed t-test was used for statistical analysis. The levels of the two hormones (mean +/- SEM) revealed that there was no evidence of hypergastrinaemia in IHPS compared with controls (75.6 +/- 16.1 and 68.1 +/- 7.8 ng l(-1), respectively), but that the level of somatostatin was significantly elevated (38.9 +/- 6.4 and 30.5 +/- 5.8 ng l(-1), p = 0.016). An inverse trend in the gastrin/somatostatin levels could not be identified in IHPS. CONCLUSION: Somatostatin but not gastrin is raised in IHPS. Somatostatin is known to inhibit the actions of inhibitory neurotransmitters in the pylorus and may explain the development of pylorospasm, which is believed to be important in the development of pyloric tumours. These results do not agree with a previous long-term follow-up study, but reflect the hormonal imbalance at the time of pyloric hypertrophy.

Biomarkers↗

PubMed2003

Gastroparesis and neuromuscular disorders of the stomach.

Gastroparesis is the most severe form of gastric neuromuscular dysfunction along a continuum that encompasses gastric visceral hypersensitivity, gastric dysrhythmias, and pylorospasm. Gastroparesis may present with vague dyspepsia symptoms or with vomiting of undigested food and weight loss. A careful history and physical examination may suggest the diagnosis of gastroparesis, but symptoms associated with gastric neuromuscular disorders are non-specific. Gastroparesis in patients with diabetes, particularly type 2 diabetes, is more common than appreciated. If gastroparesis is confirmed, then reversible causes such as mechanical obstruction of stomach and chronic mesenteric ischemia must be excluded. ''Idiopathic'' gastroparesis may follow viral infections or be due to degenerative processes that affect gastric enteric neurons, smooth muscle, and/or interstitial cells of Cajal. An approach to the diagnosis and treatment of gastroparesis and gastric neuromuscular disorders is reviewed including dietary counselling and new medical devices.

Journal Article↗

PubMed1990

[Surgical treatment of gastroesophageal reflux by modified Hill's posterior cardiopexy. Apropos of 441 cases].

Between 1972 and 1986, 490 modified Hill's procedures were performed for gastro-esophageal reflux; 441 cases were retrospectively studied consisting of 245 males and 196 females, aged from 4 days to 83 years, with a mean age of 41 years. Average duration of gastrointestinal symptoms was 5.4 years. The proposed technique is described, allowing cardiopexy without intraoperative manometry. Mortality was 1.4% (6 cases); one death was due to surgery. Morbidity was 5.4% (24 cases). With a mean follow-up of 5.2 years, a clinical cure was obtained in 93.5% of cases. Causes of failures were analyzed: the only possible pre-operative factor was the presence of peptic stenosis. Pylorospasm appeared to be a post-operative cause of failure. The 28 patients for whom surgery failed were medically treated (18), dilated (5) or reoperated (5). Three new cardiopexies and 2 fundoplications cured the last 5 patients with a mean follow-up of 5.8 years. Recurrences of symptoms and discoveries of failure were generally detected early after the operation: 20 before 6 months (71%), 1 between 6 months and 1 year, 2 between 1 and 2 years, 3 between 3 and 4 years, 1 between 4 and 5 years.

Adolescent↗

PubMed1989

[X-ray symptomatology and differential diagnosis of functional obstruction of the digestive tract in children induced by birth injuries of the spine and spinal cord].

In 60 mixed-breed white rats and 60 puppies we simulated birth traumas of the cervical spine, the spinal medulla and spinal arteries with ischaemia of the cervical medulla. Clinical, neurological and roentgenological complex investigations of 174 children with similar birth injuries revealed pathogenetic relations between birth trauma of the spine, the medulla and the functional obturations of the intestinal tract as pylorospasms, spastic-hypotonic dyskinesia of the ileum and gastroesophageal reflux. Frequent complications were aspiration pneumonia, reflux oesophagitis, oesophageal stenosis and the development of intestinal invagination due to dysrhythmic iliac peristalsis.

Animals↗

PubMed1989

[A new method of differential diagnosis and treatment of pyloric spasm].

1. In case of a pyloric spasm the proposed method uses to bring about in 90 per cent of the cases a healing effect. 2. The method appears to be effective in differentiating pyloric spasms from pyloric stenoses. 3. The method in question admits to suppose the pylorospasm to be a clinical picture of a neurosis in the pyloric part of the stomach in which the morbid neuro-reflex arc between the pylorus and the central nervous system will close. 4. The method confirms the theory of the symbiosis of pyloric spasm and pyloric stenosis in case of the pathogenesis of the pylorostenosis.

Diagnosis, Differential↗

PubMed1977

[Treatment of patients with hemorrhages due to cancer of gastric stump].

In the paper, the results of studies of gastric hemorrhages due to gastric stump cancer are reported. A total of 36 patients were treated. Eighteen patients were operated previously for gastric cancer, 12 - for ulcerous disease, 5 - for polyposis of the stomach and 1 - for pylorospasm. Roentgenological and endoscopic studies are of primary importance for establishing the diagnosis of hemorrhagic cancer of the operated stomach. The treatment of such patients was initiated with conservative measures directed at arresting the hemorrhage and normalization of homeostasis. Eighteen patients were operated upon after the arrest of hemorrhage (in 6 - radical operation was performed, in 3 - palliative, in 9 - tentative laparotomy1. The total mortality in patients with hemorrhagic cancer of gastric stump was 30.5%.

Adult↗

PubMed1979

Infant rumination syndrome: report of a case and review of the literature.

The infant rumination syndrome is an uncommon disorder difficult to differentiate from commoner conditions causing vomiting and weight loss. Its validity has recently been questioned. Its importance is heightened by the availability of newer diagnostic and operative procedures that might be misapplied. An 8-month-old male infant had been regurgitating for two months with increasing inanition. Results of diagnostic tests suggested pylorospasm or gastric pseudo-obstruction syndrome. Medical management failed. A therapeutic trial of special nursing eight hours a day resulted in rapid rehydration, weight gain, and avoidance of surgery. This case exemplifies each of the ten characteristics of the infant rumination syndrome.

Follow-Up Studies↗

PubMed1993

[Clinical studies of intra-thoracic stomach function in patients after esophagectomy and reconstruction by whole stomach].

We usually use the stomach to hung up into the chest and to the neck for esophago-gastrostomy in the patients of esophageal cancer. We had studied the intrathoracic stomach function in patients after esophagectomy with isotope 99m Tc labelled 717-resin semisolid meal for scintigram. We measured the gastric emptying time (GET) and fund the GET1/2 was no difference between the preoperative group and contrast group (P > 0.05). The study indicated that GET1/2 was faster obviously in postoperative patients with pyloroplasty than without pyloroplasty (P < 0.01). It was proved that to perform pyloroplasty with esophagostomy should be used routinely for preventing the pylorospasm, dilatation of the intrathoracic stomach and gastroesophageal reflux. At the same time, we found fasting serum gastrin (FSG) was increased (P < 0.01) in patients after esophagectomy than before, but basal acid output (BAO) decreased. It indicated that vagotomy caused the BAO decreasing and PH increasing. There were some relations between high level of FSG and postoperative diarrhea.

Esophageal Neoplasms↗

PubMed1996

[Functional, organic and histologic changes in the stomach in diabetic patients in relation to the presence of diabetic neuropathy].

Functional, organic and histological gastric changes were investigated in relation to the presence of autonomic neuropathy in 105 noninsulin-dependent diabetics (20 with autonomic neuropathy, 35 with peripheral neuropathy, 30 with both peripheral and autonomic neuropathy and 20 without neuropathy) and 40 control persons. The diagnosis of autonomic neuropathy was assessed by parasympathetic test of cardiovascular reflexes and peripheral neuropathy by classical neurological examination and EMG (Electromyogram). All subjects were examined by radiologic and endoscopic methods with gastric biopsy specimens for histologic and immunocytochemical analysis. The results of investigation showed that functional abnormalities, hiatus hernia (55%) and pylorospasm (50%) occur more frequently in patients with autonomic neuropathy. Gastritis, duodenal ulcer (5%) and polyps (25%) are significantly more frequent. Atrophic gastritis type A (20%) was more frequent in diabetics with autonomic neuropathy than in other diabetics, as well as other types of gastritis. Immunocytochemical analysis showed the presence of rare, pale ECL (Extensor Caudae Lateralis) cells in corpus and pale, hypogranulated G cells in antrum and hyperplasia and metaplasia of EC (Embryonal carcinoma) cells in antrum of the stomach. Functional, organic and histologic changes in patients with diabetic autonomic neuropathy suggest that the systemic investigation of the Gut is very important in such patients.

Diabetes Mellitus, Type 2↗