Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PYLORIC STENOSIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 523 records · Page 29Linked to original sources
PubMed1990

Infantile hypertropic pyloric stenosis in a children's hospital a retrospective study.

A total of 40 patients with a diagnosis of infantile hypertrophic pyloric stenosis were admitted to Ethio-Swedish Children's Hospital, Addis Ababa, Ethiopia over a period of 6 years (1981-1986). The clinical records of 34 patients could be retrieved and analysed. The incidence rose from 2.7 per thousand admissions in 1981 to 3.6 in 1986. The male to female ratio was 4.7:1. Patients started to vomit at a mean age of 21.5 days with age range from birth to three months. In 26 (76.4%) patients, vomiting started before the first month of life. Their distribution showed a bias towards term infants 97%, males 83.2%, first borns 26.5%, and higher socio-economic class 23.5%. No seasonal variations were observed. A palpable tumor was present in 35.3%. [Each of hematemesis with melena and jaundice were seen in 2.9%]. The treatment was pyloromyotomy; seven patients developed complications but none died.

Ethiopia↗
PubMed1998

Pyloric muscle in asymptomatic infants: sonographic evaluation and discrimination from idiopathic hypertrophic pyloric stenosis.

OBJECTIVE: To compare the morphological and functional US appearance of the pylorus in healthy infants with those suffering from idiopathic hypertrophic pyloric stenosis (IHPS) in order to determine the pathological limits and to find out the most discriminating morphometric parameter. MATERIALS AND METHODS: The pylorus of 84 asymptomatic infants was prospectively evaluated with respect to morphology (pyloric length, pyloric diameter, muscle thickness and pyloric volume) and function (gastric peristalsis and emptying, pyloric opening and the fluid passage). Results were compared with 85 patients with proven IHPS. RESULTS: In every normal infant we observed frequent pyloric opening with passage of gastric contents and quick gastric emptying. All infants with proven IHPS presented with a permanently closed pylorus and exaggerated, retrograde gastric peristalsis. For each of the four parameters, highly significant differences (P < 0.0001) were found between the control and IHPS groups. Pathological limits were 3 mm for muscle thickness (accuracy 100 %), 15 mm for pyloric length (accuracy 94 %), 11 mm for pyloric diameter (accuracy 92 %) and 12 ml for pyloric volume (accuracy 96 %). CONCLUSIONS: Evaluation of pyloric function plays an important role in the diagnosis of IHPS. The morphometric parameters are highly accurate in differentiating IHPS from a normal pylorus, muscle thickness being the most discriminating parameter.

Case-Control Studies↗
PubMed2000

A standardized feeding regimen for hypertrophic pyloric stenosis decreases length of hospitalization and hospital costs.

BACKGROUND/PURPOSE: Before the institution of a standardized feeding regimen (SFR) for hypertrophic pyloric stenosis (HPS) at the authors' institution, the postoperative feeding regimen and, thus, the length of hospitalization for HPS patients was variable. The aim of this study was to evaluate whether a SFR would affect the length of hospitalization or hospital costs for HPS patients. METHODS: A 5-year retrospective analysis was performed on 242 patients who underwent pyloromyotomy via a standard right upper quadrant incision. The length of hospitalization and hospital costs were compared in these patients before and after the institution of a standardized postoperative feeding regimen. RESULTS: The SFR decreased total length of hospitalization by 19.4% (3.1 days v2.5 days, P = .002), postoperative length of stay by 21% (1.9 days v 1.5 days, P< .001), total costs by 11.9% (P= .05), direct costs by 7.7% (P= .22), and indirect costs by 18.6% (P= .003). This occurred despite a small increase in costs per day. The SFR did not change the complication rate (5.3% before SFR v6.1% after SFR, P = 1.0). CONCLUSION: A postoperative standardized feeding regimen for patients with HPS decreased length of hospitalization and hospital costs without adverse effects.

Costs and Cost Analysis↗
PubMed1989

[Long-term results following conservative and surgical treatment of infantile hypertrophic pyloric stenosis].

UNLABELLED: From 1960 to 1970, 314 children (male:female = 3.9:1) were treated in our hospital for infantile hypertrophic pyloric stenosis (IHPS) (group 1 operatively: n = 216; group 2 conservatively: n = 98). The aim of the present study was to evaluate whether patients with IHPS do frequently have complaints in the upper gastrointestinal tract at long term. RESULTS: 1. Using the patients' files, a retrospective analysis of the familiar predisposition, symptoms, course of treatment and duration of ward treatment was made. Mortality due to operation was 0%, the postoperative rate of complications was low. 2. 17-27 years after treatment, the patients were questioned as to their subsequent health. 175 returned questionnaires able to be evaluated. According to these, only few of these patients had the symptoms of delayed gastric emptying (frequent vomiting, nausea). The velocity of gastric emptying has been measured for 53 patients for both solids and fluids (2.2 MBq 99mTc Sn colloid in a standard solid meal or in 300 ml of apple juice). There was no significant difference between the two groups, and the results were comparable to normal controls. CONCLUSION: Surgical therapy is superior to the conservative one, since the patient feels better sooner, complications are seldom and correspond with the long-term results of conservative therapy.

Adolescent↗
PubMed2006

Low plasma nitrite in infantile hypertrophic pyloric stenosis patients.

There is now substantial evidence that reduced expression of neuronal nitric oxide synthase (nNOS) is implicated in the pathogenesis of infantile hypertrophic pyloric stenosis (IHPS). This study aimed to investigate the role of plasma nitric oxide (NO) in patients with IHPS. Blood and pylorous biopsies of 13 IHPS patients were examined. The control group consisted of 19 age-matched healthy infants and 22 age-matched acute gastroenteritis patients. Plasma nitrite (NO(2-)) and nitrate (NO(3-)) levels were detected with an NO analyzer. Pylorus biopsies of 13 IHPS patients were examined for nitric oxide synthase isoform expression. Plasma nitrite levels in the 13 IHPS patients were significantly lower than in the age-matched healthy controls (0.97 +/- 0.19 vs. 3.53 +/- 0.79 microM; P < 0.001) and the acute gastroenteritis controls (0.97 +/- 0.19 vs.1.39 +/- 0.45 microM; P = 0.006). Decreased expression of nNOS in the nerve fibers of the pylorus circular muscle was found in the 13 IHPS patients. The decreased plasma nitrite levels rose to the normal range (3.27 +/- 0.77 M) after pyloromyotomy. There was no significant correlation between plasma nitrite levels and muscle wall thickness in IHPS patients. We conclude that NO is implicated in the occurrence of IHPS and the plasma nitrite level is valuable for the diagnosis of IHPS.

Female↗
PubMed1995

The epidemiology of infantile hypertrophic pyloric stenosis in New York State, 1983 to 1990.

OBJECTIVES: To investigate an apparent decline in the rate of infantile hypertrophic pyloric stenosis (IHPS) and to examine the characteristics of children with IHPS and any associated malformations. DESIGN: Cohort study in which children with IHPS were compared with the population of live births. Trends of IHPS were compared in two data sets: a population-based birth defects registry and hospital discharge data. PARTICIPANTS: Children with IHPS identified from a birth defects registry and the population of live-born infants born to residents of New York State from 1983 to 1990. MAIN OUTCOME MEASURE: Trends in the incidence of IHPS in the two data sets, and demographic characteristics and malformations associated with IHPS. RESULTS: The rate of IHPS declined from 2.4 per 1000 live births in 1984 to 1.7 in 1990. White race and male gender were associated with a higher occurrence of IHPS; high birth order, older maternal age, higher maternal education, and low birth weight were associated with lower occurrence. Seven percent of children with IHPS had a major malformation compared with 3.7% of the general population. Three major malformations occurred more frequently in children with IHPS: intestinal malrotation, obstructive defects of the urinary tract, and esophageal atresia. Fewer cases were found in the birth defects registry than in the hospital discharge data. CONCLUSIONS: Underreporting of IHPS to the birth defects registry accounts for some of the decline. Children with IHPS have more major malformations than the general population, although some of the excess could be attributed to increased detection. Further investigation is needed into the environmental factors, especially socioeconomic, associated with IHPS.

Case-Control Studies↗
PubMed2000

[Hypertrophic pyloric stenosis: sonographic monitoring of conservative therapy with intravenous atropine sulfate].

AIM: Ultrasound is the method of choice for the diagnosis of hypertrophic pyloric stenosis (HPS). The purpose of this study was to evaluate the usefulness of sonography in monitoring the efficacy of conservative therapy of HPS with intravenous atropine sulfate. METHOD: 21 infants with HPS under i.v. treatment with atropine sulfate were included. Pyloric sonomorphology, channel width and passage of gastric contents through the pyloric channel were monitored daily. The latter was examined with colour Doppler, too. If no clinical improvement was observed after 6-8 days, sonography and colour Doppler sonography played a crucial role in the decision whether to continue the conservative therapy or to perform pyloromyotomy. RESULTS: Conservative treatment was effective in 13/21 infants. In 8 patients therapy was continued as sonography demonstrated the passage of gastric contents despite lack of clinical improvement. In 4 patients, due to the sonographic findings, impending surgery could be cancelled. Colour Doppler sonography proved to be extremely useful in demonstrating passage of liquid through the narrowed pyloric channel. No significant change in pyloric morphology was seen. CONCLUSION: In HPS a conservative therapeutic approach with atropine sulfate is justified considering a success rate of 62% (13/21). During sonographic monitoring the detection of the passing of gastric content may be crucial for continuation and success of conservative therapy. In those cases colour Doppler sonography is a very useful method.

Atropine↗
PubMed1986

Secondary indigestion as a cause of functional pyloric stenosis in the cow.

In 23 cows suffering from a secondary indigestion, in most cases with septicaemia, the syndrome of functional pyloric stenosis or vagal indigestion developed. The signs were anorexia, ruminal distension with fluid material, abomasal reflux into the ruminoreticulum, dehydration, hypochloraemic, hypokalaemic metabolic alkalosis and uraemia. These signs often disappeared after treatment of both the primary causative disease and the secondary indigestion. The importance of recognising this condition is emphasised, because the serious signs of the secondary indigestion may dominate the causative disease. The prognosis depends upon the causative disease and is not necessarily bad.

Animals↗
PubMed1993

Infantile hypertrophic pyloric stenosis: where should it be treated?

A retrospective analysis in the form of an audit into the management of infantile hypertrophic pyloric stenosis in a district general hospital has revealed that the results are equivalent to that of published data from specialised units. It is stressed in this study that close co-operation has to be maintained between paediatricians and surgeons in the care of these infants. The diagnosis can be made on clinical grounds in the majority of cases. The operation has to be carried out by experienced surgeons and anaesthetists. The morbidity can be minimised under these circumstances and pyloromyotomy can be performed safely in a district general hospital.

Female↗
PubMed1994

Contribution of endoscopy to early diagnosis of hypertrophic pyloric stenosis.

The diagnostic accuracy of ultrasonography and gastrointestinal endoscopy was compared in 63 infants who were operated on for infantile hypertrophic pyloric stenosis. Endoscopy was far more accurate than ultrasonography, the diagnosis being made in 97 and 81% of the cases, respectively. The difference between the techniques was even more obvious in the younger patients and in those with a short history of vomiting. The ability to detect coexistent or other causes of vomiting with endoscopy appeared advantageous. The endoscopic procedure is easily done without general anesthesia and was without complications in our series. We recommend endoscopy as an important tool in very young patients with few clinical signs other than vomiting, allowing for appropriate treatment without delay.

Endoscopy↗
PubMed2001

Motor abnormality in the gastroduodenal junction in patients with infantile hypertrophic pyloric stenosis.

BACKGROUND/PURPOSE: Periodic clusters of phasic pressure waves in the gastroduodenal junction (GDJ) have been seen in patients with infantile hypertrophic pyloric stenosis (IHPS). This study investigated the details of these pressure waves in relation to disturbed transpyloric flow in IHPS. METHODS: Manometric study was performed in 11 IHPS patients before and after atropine therapy and 2 non-IHPS infants. Pressure changes in the GDJ were measured with an 8-channel sleeve or a 9-channel sidehole micromanometric assembly under fluoroscopic control for 2 hours. RESULTS: Clusters of phasic pressure waves (365 +/- 42 mm Hg) associated with an increase in basal pressure (10 +/- 3 mm Hg) were intermittently observed in the GDJ in all IHPS patients. Similar observations were not made in the non-IHPS infants. Most antral pressure waves occurred simultaneously with those pressure waves in the GDJ in the IHPS patients. Atropine (0.01 mg/kg) transiently abolished the phasic and tonic pressure waves for 19 +/- 10 minutes. Significantly fewer phasic pressure waves were observed after atropine therapy. CONCLUSIONS: Characteristic phasic and tonic contractile activity in the GDJ is uncoordinated with the antral contractions in IHPS patients. Such incoordination may be an important factor in the disturbed transpyloric flow in IHPS.

Atropine↗