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At least 19 recordsLinked to original sources
PubMed1987

[Morphologic findings in hypertrophic pyloric stenosis (pyloric spasm)].

According to our morphological investigations (special clearance technique - light-polarized microscopy - systemically suitable histological sections) congenital hypertrophic pyloric stenosis is an impressive example for a closure mechanism by stretching: caused by constructive elongation the lumen of the primary narrow segment (canalis pyloricus) becomes nearly closed. On the contrary a disease related to pyloric dilatation is not known. Normal findings are compared to pathological observations and thereby the principle of the "Dehnverschluss" is explained by synoptically.

Adult↗
PubMed1996

The ontogeny of the peptide innervation of the human pylorus, with special reference to understanding the aetiology and pathogenesis of infantile hypertrophic pyloric stenosis.

Pyloric stenosis (PS) is a common condition in infancy, which is associated with smooth muscle hypertrophy that results in pyloric outlet obstruction. The author examines the ontogeny of the peptide innervation of the pylorus in fetal tissues and an experimental model in mice and evaluates the histochemical and morphological changes in the pylorus. The data suggest that PS is an intrauterine lesion that occurs by 12 weeks' gestation. This is associated with diminished nitric oxide in human tissues and reduced enzyme activity (resulting from a deficiency in an enzyme cofactor) in mice. Increased vasoactive intestinal polypeptide expression in pyloric myenteric ganglia may be an intrinsic mechanism for resolving this condition.

Animals↗
PubMed1995

Pyloric size in normal infants and in infants suspected of having hypertrophic pyloric stenosis.

Pyloric muscle thickness (PMT) and pyloric diameter (PD) were determined by sonography in 92 healthy infants aged 8 to 70 days. PMT and PD measured median 2.0 mm and 10.0 mm. There was a significant correlation between the pyloric dimensions and the infant's age, p < 0.02 and p < 0.00001 for PMT and PD, respectively. In 26 infants with an initial diagnosis of hypertrophic pyloric stenosis (HPS), but with a final diagnosis of no HPS the mean figures were 2.4 and 11.0 mm, and in 21 infants with HPS, confirmed at surgery, the figures were 4.0 and 14.0. The pyloric dimensions in the 3 groups differed significantly. The larger-than-normal pyloric dimensions in the "no HPS" group suggest that some of these patients suffered from milder degrees of HPS.

Age Factors↗
PubMed1996

The endoscopic diagnosis of pyloric stenosis.

Pyloric stenosis, a relatively common surgical problem in infancy, is often straightforward in its clinical presentation and diagnosis. Here we describe two unusual cases where the normal diagnostic measures failed, and an unusual alternative, endoscopy, was a means to the correct diagnosis.

Diagnosis, Differential↗
PubMed2004

Foveolar hyperplasia secondary to cow's milk protein hypersensitivity presenting with clinical features of pyloric stenosis.

Pyloric stenosis is one of several causes of infantile nonbilious vomiting. A 7-week-old boy presenting with symptoms suggestive of this was found to have a prepyloric lobular mass causing near-complete gastric outlet obstruction. The histology showed localized hypertrophic gastropathy with hyperplasia and tortuosity of foveolar cells reminiscent of Menetrier changes. Postsurgical excision, the child continued vomiting until removal of bovine and soy proteins from his diet. The clinical presentation, pathology, and response to restrictive diet suggested cow's milk protein allergy as key. The literature describing infantile focal foveolar hyperplasia and Menetrier disease is reviewed, stressing the rarity of allergy as cause.

Animals↗
PubMed1991

Pyloric stenosis.

Infantile pyloric stenosis is the most frequently encountered infant gastrointestinal obstruction in most general hospitals. Although the primary therapy for pyloric stenosis is surgical, it is essential to realize that pyloric stenosis is a medical and not a surgical emergency. Preoperative preparation is the primary factor contributing to the low perioperative complication rates and the necessity to recognize fluid and electrolyte imbalance is the key to successful anaesthetic management. Careful preoperative therapy to correct severe deficits may require several days to ensure safe anaesthesia and surgery. The anaesthetic records of 100 infants with pyloric stenosis were reviewed. Eighty-five per cent of the infants were male (i.e., 5.7:1 male to female ratio) 12% were prematures. Surgical correction was undertaken at an average age of 5.6 wk, and the average weight of the infants at the time of surgery was 4 kg. A clinical diagnosis of pyloric stenosis by history and physical examination alone was made in 73% of the infants presenting to The Hospital for Sick Children. All the infants received general anaesthesia for the surgical procedure and there were no perioperative deaths.

Anesthesia↗
PubMed1995

Trophic effects in the acid-producing part of the rat stomach after pyloric stenosis.

BACKGROUND: Pyloric stenosis produces gastric hypersecretion and is thought to stimulate the growth of the gastric mucosa in the rat, the dog, and man. However, the mechanisms behind the hypersecretion and the trophic effect of pyloric stenosis are little known. The purpose of the present study was to examine whether the postulated trophic effects described include growth of the histamine-producing enterochromaffin-like (ECL) cells and whether circulating gastrin can be held responsible. METHODS: Pyloric stenosis was produced in rats by tying a ligature around the pylorus, thereby narrowing the passage through the sphincter. The animals were left for 4 to 12 weeks. RESULTS: The operation dilated the stomach, increased the serum gastrin concentration approximately twofold, and increased the oxyntic mucosal weight, volume, and surface area but not the mucosal thickness and total DNA content. The interglandular space was increased, and the DNA concentration was reduced. The density of the ECL cells (that is, the number of ECL cells per visual field) was reduced at 4 weeks and back to control values at 8 and 12 weeks. The calculated total volume of the ECL cell population was unchanged at first but showed a less than twofold increase 12 weeks after the operation. The volume density of the ECL cells (that is, the proportion of the mucosa made up of ECL cells) was reduced at 4 and 8 weeks and was back to normal at 12 weeks. The ECL cells are rich in histidine decarboxylase (HDC); whenever the cells are stimulated, the enzyme activity increases. The HDC activity in the oxyntic mucosa was reduced at first and returned to control values 12 weeks later. CONCLUSIONS: Pyloric stenosis per se does not affect the total number of oxyntic mucosal cells, but causes the ECL cell population to grow somewhat, probably because of the moderate hypergastrinemia. Interestingly, however, there was no increase in the HDC activity, suggesting that the ECL cells are not much activated by the operation.

Animals↗
PubMedDate not supplied

Muscle thickness in infants hypertrophic pyloric stenosis.

Hypertrophic pyloric stenosis (IHPS) is the most common abdominal abnormality requiring surgery in infants. It occurs due to the hypertrophic and hyperplasia of the muscular layers of the pyloric. The usual age of clinical presentation is about three weeks of life. The most important symptom is non bilious emesis, intermittent or after each feeding. From march 1996 to June 2001, 21 infants, 20 males and 1 female, were subjected to ultrasonographic, radiographic exams and after diagnosis to the pyloromyotomy extramucosa. Ultrasonography was the study of choice used to identify hypertrophic pyloric stenosis; the markers to analyse were the length and the overall diameter of the pyloric canal and the muscle thickness of the wall. The results showed that a length of the pyloric canal 20 +/- 6 mm, a diameter 13.6 +/- 2.5 mm and a muscle thickness 4.1 +/- 1 mm are diagnostics for hypertrophic pyloric stenosis.

Female↗
PubMed2005

Antral web associated with distal antral hypertrophy and prepyloric stenosis mimicking hypertrophic pyloric stenosis.

A 3-year-old boy presented with postprandial vomiting and epigastric pain for 3 wk. Barium meal study suggested hypertrophic pyloric stenosis. Ultrasound of the stomach after water loading revealed an echogenic antral web with an eccentric aperture and distal antral hypertrophy. Subsequent endoscopy confirmed the ultrasound findings. Web resection and antropyloroplasty resulted in excellent recovery. To our knowledge, the barium meal and ultrasound findings of an antral web-associated distal antral hypertrophy and prepyloric stenosis has not previously been described.

Barium↗
PubMed2002

Ultrasound diagnosis of infantile hypertrophic pyloric stenosis: determinants of pyloric length and the effect of prematurity.

AIM: To evaluate the determinants of sonographic measurements of pyloric length and muscle thickness in infants with hypertrophic pyloric stenosis (HPS) and to determine whether infants born prematurely have proportionately smaller measurements. MATERIALS AND METHODS: A retrospective review was carried out of 190 infants operated on for HPS at Bristol Children's Hospital over a 5-year period. Sonographic measurements of pyloric length and muscle thickness were related to age, history of prematurity, weight, sex and family history of HPS. RESULTS: Pyloric length in infants with HPS was significantly greater in those born at term compared to those born prematurely (18.6 mm [SD 2.2] vs 17.3 mm [SD 3.1], P = 0.043); this was explainable by body weight, with length increasing by 1.13 mm (SE 0.35) per kilogram (P = 0.002). There was no significant relationship with measured muscle thickness. CONCLUSION: Sonographic measurement of pyloric length is strongly correlated with the weight of the infant, irrespective of other factors. The relationship of length and weight may be useful in confirming the presence of HPS in small and premature infants.

Birth Weight↗
PubMed1959

Hypertrophic pyloric stenosis.

Hypertrophic pyloric stenosis, a relatively common condition, is caused by hyperplasia of the musculature of the pylorus. The diagnosis is made by a history of projectile vomiting and failure to gain weight, the observation of gastric peristaltic waves, and the palpation of a pyloric "tumor." A method of palpating this tumor is described in detail. Roentgenological studies are rarely indicated. Pylorotomy for treatment of hypertrophic pyloric stenosis was not successful until the development of necessary supporting measures. Preparation for operation consists of intravenous administration of fluids and electrolytes and sometimes serum or whole blood. The position of the tumor governs the choice between two different incisions. The operative procedure herein described is essentially that devised by Ramstedt many years ago, with modifications to facilitate the procedure.

Body Fluids↗
PubMed1995

[Anesthesia in hypertrophic pyloric stenosis].

Hypertrophic pyloric stenosis is one of the most common gastrointestinal abnormalities occurring in the first six months of life. It is a medical emergency and surgical therapy is considered only after correction of fluid and electrolyte deficits. Careful preoperative therapy to correct deficits may require several days to ensure safe general anaesthesia and surgery. The anaesthetic management of 58 consecutive infants (51 male, 7 female) with congenital hypertrophic pyloric stenosis over a 4-year period is reviewed. Mean age was 39.5 days (range 13-100), mean weight was 3.95 kg (range 2.4-5.3). Elective Ramstadt's fibromyotomy was performed after water-electrolyte balance restoration. Inhalation induction was made and oro-tracheal intubation achieved with succinylcholine 1.5 mg/kg-1. General anaesthesia was performed without complications. All patients were discharged during the period between the 2nd and 7th day after surgery, except one who was discharged after 16 days because of dehiscence of the surgical wall. Preoperative preparation is the primary factor contributing to the low perioperative complication rates, and the necessity to recognize fluid and electrolyte imbalance is the key for a successful anaesthetic management.

Anesthesia, Inhalation↗