"Congenital" pyloric stenosis.
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Between 1919 and 1941, 71 infants suffering from pyloric hypertrophy were operated on by Ramstedt performing an extramucosal pyloromyotomy. Of these patients, we could identify and investigate 41. Four out of 31 long-term surviving patients have been Billroth II-resected (BII). One of these needed re-resection because of an anastomotic ulcer. None of all the long-term survivors developed a carcinoma. Two patients were treated conservatively because of gastritis and one because of esophagitis. All patients, except the one requiring re-resection and one suffering from maldigestion, were absolutely free of complaints. The average time between operation and re-checking was 57 years. The oldest patient was examined 72 years after the operation.
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The efficacy of pneumatic dilatation with Rigiflex balloons as a treatment for pyloric peptic stenosis was tested in 18 patients. The patients underwent endoscopic dilatation in one sitting, the size of the balloons being gradually increased for a total of 3 minutes. Patients were also treated with omeprazole in the follow-up period. Pneumatic dilatation of upper digestive tract strictures has proved to be an effective and safe technique, showing remarkable advantages over the traditional surgical treatment. It could represent the first step in a therapeutic approach.