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Results for “PYLORIC STENOSIS”

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PubMed1986

Sonography of the normal and abnormal stomach (excluding hypertrophic pyloric stenosis in children.

Prospective sonographic evaluation after water ingestion in 25 normal children aged 2 days to 15 years (mean 6.3 years) demonstrated that normal gastric wall thickness was less than 3 mm. Gastric walls of 5-15 mm thickness were seen in nine of about 6500 children undergoing abdominal sonographic examinations. These nine patients had a variety of unusual diseases, including varioliform gastritis, gastric ulcer, lymphoid hyperplasia, and gastric hamartoma. Previously unreported sonographic appearances were seen. The sonographic examination was instrumental in the detection of five clinically unsuspected gastric lesions and helpful in follow-up in four others.

Adolescent↗
PubMed1979

[Low esophageal stenosis and pyloric obstruction: 2 complications of a Prioton clip].

The authors report a case of digestive hemorrhage due to rupture of oesophageal varices, for which treatment by means of a Prioton oesophageal clip was effective but followed by two rare complications: pyloric stenosis by migration of the balloon of the gastrostomy catheter and retention of the clip which required its removal by oesophagotomy. Analysis of the mechanism of these complications rarely encountered in the literature suggests a method of prevention.

Esophageal Stenosis↗
PubMedDate not supplied

[Hypertrophic stenosis of the pyloric canal: genetic and familial incidence].

The Authors hereby review the literature concerning hypertrophic pyloric stenosis, with particular reference to the genetic and familial influence. They present their cases of 49 children; out of these 3 pairs of biovular twins out of which only one of the twin babies was affected and 2 similar twins both of which were affected. In conclusion they are confirming the importance of a genetic component, influenced by environmental factors, on the origin of hypertrophic pyloric stenosis.

Diseases in Twins↗
PubMed2000

[Pyloric hypertrophic stenosis in the premature child. A clinical case].

Hypertrophic pyloric stenosis (HPS) is rare in premature infants. We report a case of HPS in an extremely low birth weight neonate (28 weeks of gestation, 622 gr), discovered on the 10th week of life. Although the diagnosis and treatment of pyloric stenosis has ben well established for many years, the presentation in preterm babies is atypical and the diagnosis often delayed. A brief review of literature is included.

Humans↗
PubMed1990

[Classification of peptic ulcer].

To make more simple and useful classification of peptic ulcer the following criteria of the above classification are proposed: nosological entity (ulcer), form (primary, recurrent), site (subcardial, mediogastric, antral, pyloric. duodenal bulbar and duodenal retrobulbar), activity (A-III--a severe exacerbation, A-II--a moderate exacerbation, A-I--clinical remission, A-0--complete remission), clinical course (severe, moderate, light, latent), complications (perforation, hemorrhage, penetration, malignant transformation, pyloric stenosis compensated, pyloric stenosis decompensated).

Humans↗
PubMed1990

[Stenosing gastroduodenal ulcer in children. Apropos of 3 cases].

Three cases of stenosing peptic ulcers in young children (age 21 months, 6 years and 8 years) are reported. During infancy, peptic ulcer is the main cause of pyloric stenosis after pyloric hypertrophy. The stenosis reveals or complicates primary gastric or duodenal ulcers. A complete cure can only be obtained with medical treatment.

Child↗
PubMed1989

[Reliability of ultrasonic diagnosis in hypertrophic stenosis of the pylorus].

Ultrasound diagnosis of pyloric stenosis depends on the typical "target" and "cervix" pictures, respectively in transverse and longitudinal scan. Furthermore, pyloric dimensions can be considered pathologic when the muscular wall is greater than or equal to 4 mm. in width, having a maximum diameter greater than or equal to 5 mm. and the pyloric canal is greater than or equal to 18 mm in length. At the Department of Paediatric Surgery of Parma, from 1986 to 1988, 34 infants were studied by ultrasound, basing on clinical suspect of pyloric stenosis. 22 of them were subsequently operated on. Pyloric ultrasound was diagnostic in 20 cases, negative in 1 and doubtful in 1, confirming its reliability in 90-95% of cases. No false positive findings were recorded. Basing on these results, the Authors believe that ultrasound must be the first choice in case of clinical suspect of pyloric stenosis in infancy, because of its high diagnostic value and safety. X-ray studies should be indicated only in doubtful cases.

Evaluation Studies as Topic↗
PubMed2000

[Selective proximal vagotomy in combination with drainage operations in duodenal ulcers].

From 1989 to May 1999 selective proximal vagotomy (SPV) was performed in 400 patients with duodenal ulcer, 190 (47.5%) of them had pyloric stenosis. Various drainage operations were performed in 180 patients with stenosis, in 10 patients compensated pyloric stenosis was eliminated by excision of the scars around the ulcer. Out of 210 patients without pyloric stenosis drainage operations were performed in 23 (11.0%) patients with large penetrating duodenal ulcers, which at healing could cause stenosis. The best results were received after SPV in combination with drainage operations, which save the pyloric mechanism of gastric evacuation--transverse duodenojejunostomy (5) and duodenoplasty (15); the results after them do not differ from results after SPV without drainage operations.

Adolescent↗
PubMed1985

[Selective proximal vagotomy in stenosing and penetrating duodenal ulcer].

In duodenal ulcer with complete pyloric stenosis selective proximal vagotomy in connection with either pyloric dilatation or duodenoplasty is generally indicated. Pyloroplasty may still be considered as an acceptable alternative drainage procedure. In high risk patients with pyloric stenosis, especially in the very old, truncular vagotomy with an adequate drainage is the operation of choice because of its low operative trauma. Penetrating ulcers are treated by selective proximal vagotomy only. Postoperative pyloric stenosis occurs rarely and should be managed by secondary pyloroplasty or pyloric dilatation.

Adolescent↗
PubMed1984

[Echographic diagnosis of hypertrophic stenosis of the pylorus].

We reviewed the abdominal sonograms of thirty three infants presenting with vomiting. Thirty patients were clinically suspected of having hypertrophic pyloric stenosis. The thickened pyloric muscle was seen as a hypoechoic mass with strong central echoes, situated medial to the gallbladder, and anterior to the right kidney and caval vein, in transverse and longitudinal sections respectively. The muscle thickness measured between 3.8 and 7 mm. These findings were found in thirty infants, in 27 of whom the diagnosis was clinically suspected, and the other three were presumed to have gastroesophageal reflux. All of them had subsequent confirmation of hypertrophic pyloric stenosis by upper gastrointestinal tract examination and/or surgery. Real time ultrasound is considered a useful, quick, reliable and non invasive method to confirm the hypertrophic pyloric stenosis in infants with vomiting.

Constriction, Pathologic↗
PubMed2003

Oral erythromycin prophylaxis vs watchful waiting in caring for newborns exposed to Chlamydia trachomatis.

BACKGROUND: Chlamydia trachomatis exposure at birth may cause conjunctivitis or pneumonia. Until recently, a course of oral erythromycin prophylaxis was recommended for C trachomatis-exposed neonates. However, recognition of an association between erythromycin and pyloric stenosis prompted a change to a watchful waiting recommendation under which only infants who develop symptomatic C trachomatis infection are treated with oral erythromycin. OBJECTIVE: To compare erythromycin prophylaxis with watchful waiting for a hypothetical cohort of 100 000 neonates exposed to C trachomatis. METHODS: In a decision tree, potential outcomes were C trachomatis conjunctivitis, C trachomatis pneumonia (which could require inpatient or outpatient therapy), no clinical disease, and pyloric stenosis. Published data were reviewed to derive probability point estimates and ranges. Estimated charges served as outcome measures. RESULTS: Watchful waiting is less expensive than erythromycin prophylaxis ($15.1 million vs $28.3 million); prophylaxis prevents 5986 cases of C trachomatis pneumonia, including 1197 hospital admissions, but causes 3284 pyloric stenosis cases. (For every 30 infants given oral erythromycin prophylaxis, one additional case of pyloric stenosis would be expected to occur, and approximately 1.8 cases of C trachomatis pneumonia would be prevented.) In sensitivity analyses, if more than 3.4% of exposed neonates are hospitalized for C trachomatis pneumonia, prophylaxis becomes favored. CONCLUSIONS: This study supports the watchful waiting recommendation for asymptomatic C trachomatis-exposed neonates. However, there are wide plausible ranges for pyloric stenosis risk after erythromycin administration and for the incidence of C trachomatis pneumonia severe enough to require hospitalization; under some combinations of these rates, prophylaxis could be favored.

Anti-Bacterial Agents↗
PubMed1987

[Pyloric motor activity and function with special reference to pyloroplasty after vagotomy].

Using adult mongrel dogs, pyloric motor activity and gastric emptying observed by phototransducer (P.T.) under anesthesia and by strain gage transducer (S.G.T.) under consciousness. Pyloric motor activity and function were investigated in the dogs with distorted pylorus after instorations of Daclon tube, pyloric resection and pyloric stenosis. The pyloric sphincter responses to gastrin, pancreozymin, secretin, glucagon, atropine, morphine, naloxone and enkephalin administrated intravenously were observed. Gastroduodenal motor activity in relation to the changes of gastrointestinal hormone levels were measured before and after truncal vagotomy (TV) and selective proximal vagotomy (SPV) with or without pyloroplasty. Results are summarized as follows; 1. The pyloric motility recorded by P.T. was well correlated with the contractile activity recorded by S.G.T. under the anesthesia, although the pylorus was never completely closed and showed tonic movements. 2. The pyloric motor activity under the consciousness was different from gastric and duodenal motor activity. 3. After SPV, the gastrin responses to the test meals were significantly increased so that the pyloric motility was disturbed. The fact mentioned above, the pyloric functional disorder after the SPV was partly due to the hypergastrinemia. Pyloroplasty for the SPV inhibited the serum gastrin level. It was suggested that the pyloroplasty for the SPV was necessary to prevent possible hypergastrinemia after SPV.

Animals↗
PubMed1991

Antropyloric muscle thickness at US in infants: what is normal?

The authors reviewed the ultrasonographic (US) images and medical records of 145 consecutive infants who were seen for evaluation of the upper gastrointestinal tract because of chronic vomiting and/or regurgitation. At US, the antropyloric muscle of each patient was measured in the midlongitudinal plane. On the basis of this measurement, the patients were divided into the following categories: group 1 (1-2 mm; 99 patients), group 2 (greater than or equal to 3 mm; 40 patients), and group 3 (2- less than 3 mm; six patients). Patients in group 1 were considered to have normal antropyloric muscle thickness, those in group 2 had abnormal thickness, and those in group 3 had muscle thickness that was not definitely normal or abnormal. The final clinical diagnoses for all of the infants in the three groups confirmed the authors' initial impressions that antropyloric muscle thickness of less than 2 mm was anatomically normal, muscle measuring 3 mm or greater was abnormal and diagnostic for pyloric stenosis, and muscle from 2 to less than 3 mm was abnormal but not specifically diagnostic for pyloric stenosis. Two of the six patients in group 3 eventually were diagnosed as having pyloric stenosis; thus, the authors believe that only those patients with antropyloric muscle less than 2 mm thick should be considered unequivocably normal.

Female↗
PubMed2002

Differences in outcome with subspecialty care: pyloromyotomy in North Carolina.

BACKGROUND/PURPOSE: Proponents of subspecialization in surgery claim that fellowship training improves the quality of care. Others claim that general training is adequate for most routine surgical procedures. The authors questioned whether there were differences in outcomes when general surgeons (GEN) operate on children and infants with common surgical conditions compared with the care of their pediatric surgical (PED) colleagues. METHODS: The authors retrospectively reviewed the Healthcare Investment Analysts North Carolina Information Network database to identify patients who underwent pyloromyotomy for congenital hypertrophic pyloric stenosis in North Carolina during the period from October 1995 through September 1998 (n = 780). Information obtained included demographics, insurance type, hospital, length of stay, total hospital charges, occurrence of mucosal perforation, and type of surgeon (general v pediatric). RESULTS: Of the 780 pyloromyotomies performed, 363 (48%) were performed by pediatric surgeons. Pediatric surgeons cared for more Medicaid patients than general surgeons (PED, 52% v GEN, 40%; P =.001). Infants treated by pediatric surgeons had a lower incidence of mucosal perforation (PED, 0.5% v GEN, 2.9%; P =.0015), which was associated with decreased overall total hospital charges (no perforation, $4,806 plus minus 79 v perforation, $6,592 plus minus 492; P =.002). When patients with uncomplicated pyloric stenosis were evaluated (96% of cases), those cared for by pediatric surgeons had lower total hospital charges (PED, $4,496 plus minus 95 v GEN, $5,121 plus minus 121; P =.0001) and shorter length of stay (PED, 2.7 plus minus 0.1 days v GEN, 3.1 plus minus 0.1 days; P =.01). CONCLUSIONS: In North Carolina, general surgeons treat more than half the patients who have pyloric stenosis, though fewer with Medicaid. The cost and incidence of mucosal perforation were increased in infants with pyloric stenosis when care was provided by general rather than pediatric surgeons.

Databases as Topic↗