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[Congenital pyloric atresia. Report of three cases (author's transl)].

Congenital pyloric atresia is a relatively unusual condition. From three cases the authors point out the diagnosis basis. The main clinical findings are hydramnios, early non bilious vomiting and epigastric distension. Diagnosis is based upon abdominal plain films. They demonstrate an air dilated stomach, and no air distal to the pylorus. When films can be taken in the upright position, they demonstrate a single intragastric air-fluid level. Radiologic findings are essential, because surgical inspection alone fails to demonstrate membranous atresia and cordonal atresia which are more frequent than total atresia. In the two former conditions, radiologic findings lead the surgeon to look for the obstruction by the mean of a catheter introduced by a juxta-pyloric antrotomy.

Female↗

Superior mesenteric artery syndrome. A case report.

A case of superior mesenteric artery syndrome is reported. A 16-year-old boy with bilious vomiting for six months and weight loss within the previous year is presented. In this symptomatic period, he was fed many dietary formulations. This conservative management failed. Physical examination revealed that he was malnourished. The diagnosis was made by means of an upper gastrointestinal barium study performed through a tube. Gastrojejunostomy was preferred over duodenal mobilization because he had a markedly dilated stomach and enlarged pylorus. The postoperative course was satisfactory.

Adolescent↗

[Acute dilatation of the stomach in children. Apropos of 6 cases].

Six cases of acute gastric dilatation in children are reported. Clinical features of the syndrome are gastric distension, respiratory failure, dehydration and electrolyte disturbances. This potentially lethal pathology is well controlled by elementary therapeutics : gastric fluid suction and rehydration with electrolyte supplementation. Autonomic nervous system seems directly involved in the occurrence of these troubles, but pathophysiology remains unclear. In this way, one should carefully discuss the diagnosis with the aim of precisely discarding any underlying pathology (as in our case n. 6).

Acute Disease↗