Maternal smoking and risk of hypertrophic infantile pyloric stenosis: 10 year population based cohort study.
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A complete failure of gastric emptying followed pyloro-myotomy in a pre-mature infant with a fatal outcome. The causation of an incomplete myotomy with duplication of the pylorus or a genetically determined condition are discussed.
The parameters of proteinogram were studied in 182 patients. It was shown that autotransfusions of UV-irradiated blood was an effective measure for the correction of the disturbed protein metabolism.
We describe a rare case of hyperplastic polyp of the stomach having its clinical origin in the neonatal period and initially stimulating hypertrophic stenosis of the pylorus. After this neoformation, which almost completely obstructed the pylorus, was endoscopically removed, vomiting ceased and a rapid weight gain was observed. It is known that tumors are a rare cause of gastric outlet obstruction if compared with hypertrophic stenosis of the pylorus. However, our experience suggests that in the case of atypical symptoms, the investigations should be extended, especially to endoscopic examination of the upper digestive tract.
We have reported a case of gastrocolic fistula with gastric outlet obstruction as a complication of benign gastric ulcer. The single-stage surgical procedure described resulted in a successful outcome. Benign gastric ulcer currently appears to be the most prevalent cause of gastrocolic fistula.
In the introduction the author deals with the genesis, symptoms and treatment of pylorostenosis. He presents then several interesting cases from his 30 years' surgical material which had an uncommon pathogenesis. The latter was congenital, several times inflammatory, traumatic, lithogenic and tumorous. Consistent with data in the literature, he recommends early surgical treatment of benign gastric lesions as well as optimal prevention of severe complications.
A 47-year-old man presented with epigastric pain relieved by bilious vomiting since one month. He had undergone truncal vagotomy with posterior gastrojejunostomy for benign gastric outlet obstruction 2 years ago. Endoscopy showed distension and stasis in the afferent loop, bile gastritis and esophagitis. Laparoscopic Braun jejunojejunostomy relieved his symptoms.
Mucosal perforation during Fredet-Ramstedt pyloromyotomy is the cause of unnecessary morbidity and death if unrecognized. Previously, a variety of closure have been advocated. In 1,777 cases there has been 42 (2.3%) intraoperative perforations. One unrecognized perforation led to a postoperative death. Closure of a mucosal tear is accomplished safely by a simplified suture technique without prolonged convalescence or death.