scholarly journals A clinical study of gastric outlet obstruction

2016 ◽  
Vol 4 (1) ◽  
pp. 264
Author(s):  
Suresh Clement H. ◽  
Ram Prasad Cherukumalli ◽  
Ch. Ravinder Rao
Keyword(s):  
Duodenal Ulcer ◽  
Pyloric Stenosis ◽  
Gastric Outlet Obstruction ◽  
Hypertrophic Pyloric Stenosis ◽  
Duodenal Bulb ◽  
Outlet Obstruction ◽  
Palliative Surgery ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Age Group ◽  
Carcinoma Stomach

Background:From the standpoint of pathology, the term pyloric stenosis is usually inaccurate at least in adult patients, since the site of obstruction is rarely situated at the pylorus itself but, is more often placed immediately proximal to the spinchter where the diagnosis of carcinoma is most probable or more distally in the duodenal bulb where the cause is almost invariably a duodenal ulcer. The aim was to study infantile hypertrophic pyloric stenosis, benign peptic ulcer and gastric carcinoma and evaluation of electrolyte abnormalities in gastric outlet obstruction, to study various modalities of treatment and to assess pertaining to recovery from paralytic ileus.  Methods: This was a clinical observational study comprising of 40 cases of gastric outlet obstruction. The patients for this study have been selected from Prathima Institute of Medical Sciences, Karimnagar, Telangana, India from December 2013- November 2015. The cases were selected who were willing to undergo surgery.Results:Congenital hypertrophic pyloric stenosis (CHPS) is more common among first born male infants. Parental consanguinity is associated with increased incidence of congenital hypertrophic pyloric stenosis. CHPS is common in the age group of first 3-6 weeks of life (average 4 weeks). Males are more commonly affected with gastric outlet obstructions in adults. Cicatrized duodenal ulcer is more common in the age group of 30-40 years, while carcinoma stomach is more common in age group of 50-60 years. Vomiting and visible gastric peristalsis are the most common and constant symptom and sign of gastric outlet obstruction, more so in cases of cicatrized duodenal ulcers.Conclusions:Ramstedt’s pyloromyotomy is the gold standard treatment for CHPS. Patients with gastric outlet obstruction due to cicatrized duodenal ulcer require truncal vagotomy with posterior gastrojejunostomy. Vagotomy is optional in view of better response with drugs for APD. Antral carcinoma cases require curative or palliative surgery depending on the stage of the disease.

scholarly journals Postoperative gastric Outlet Obstruction following hiatal hernia repair in an infant: A case report

2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Dr Muhammad Jawad Afzal ◽  
Shabbir Ahmad ◽  
Farrakh Mehmood Satar ◽  
Sajid Iqbal Nayyer ◽  
Muhammad Bilal Mirza ◽  
...  
Keyword(s):  
Hiatal Hernia ◽  
Pyloric Stenosis ◽  
Gastric Outlet Obstruction ◽  
Hypertrophic Pyloric Stenosis ◽  
Outlet Obstruction ◽  
Hiatal Hernia Repair ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Intrathoracic Stomach ◽  
Case Presentation ◽  
Male Baby

Background: Infantile hypertrophic pyloric stenosis (IHPS) is an exceedingly rare cause of postoperative emesis in a case of hiatal hernia. Occasionally it may simulate other etiology of gastric outlet obstruction. Case Presentation: A 32-day-old male baby presented with respiratory distress and vomiting since birth. Diagnosis of eventration of left hemi diaphragm was made on CT Chest. At surgery, hiatal hernia with an intrathoracic stomach was found, which was repaired. On 5th postoperative day, the baby developed vomiting after feeding which gradually turned to be projectile in nature over a week. Contrast meal performed showed malpositioned stomach with delayed emptying. At re-operation, a well-formed olive of pylorus was encountered; Ramstedt pyloromyotomy was done. Postoperative course remained uneventful. Conclusion: IHPS is a rarely described association with hiatal hernia. Pyloric stenosis should be considered in differential diagnoses of postoperative emesis in infants with hiatal hernia.

scholarly journals S3207 Ectopic Location of Ampulla of Vater in the Duodenal Bulb Causing Pyloric Stenosis and Gastric Outlet Obstruction

2021 ◽  
Vol 116 (1) ◽  
pp. S1319-S1319
Author(s):  
Dawa Gurung ◽  
Howard Chung ◽  
Mahmoud Nassar ◽  
Mohsen Alshamam ◽  
Saphwat Eskaros ◽  
...  
Keyword(s):  
Pyloric Stenosis ◽  
Gastric Outlet Obstruction ◽  
Duodenal Bulb ◽  
Outlet Obstruction ◽  
Ampulla Of Vater

The Value of Ultrasound in the Diagnosis of Congenital Hypertrophic Pyloric Stenosis

1993 ◽  
Vol 32 (5) ◽  
pp. 281-283 ◽  
Author(s):  
Marcos Kovalivker ◽  
Ilan Erez ◽  
Nina Shneider ◽  
Ernesto Glazer ◽  
Ludwig Lazar
Keyword(s):  
Pyloric Stenosis ◽  
Gastric Outlet Obstruction ◽  
Clinical Picture ◽  
Hypertrophic Pyloric Stenosis ◽  
Barium Meal ◽  
Outlet Obstruction ◽  
Sonographic Diagnosis ◽  
Congenital Hypertrophic Pyloric Stenosis ◽  
Clinically Significant ◽  
Pyloric Muscle

The charts of 103 children with a clinically and surgically confirmed diagnosis of congenital hypertrophic pyloric stenosis were retrospectively reviewed. We found a significant correlation between sonographic and surgical measurements of the muscular thickness of the pylorus ( r = .987, P<.001). In 73.7% (76 cases), the clinical picture of gastric outlet obstruction was present when the thickness of the enlarged pyloric muscle was 3.0 mm or more. In 26.3% (27 cases), the pyloric muscle was less than 3.0 mm wide. For 10 patients in whom the muscle width was less than 2.5 mm by sonography, a barium meal was necessary to confirm the diagnosis. The width of the pyloric muscle is the most important factor in the sonographic diagnosis of pyloric stenosis, and even a width of less than 3.0 mm may be associated with clinically significant obstruction.

scholarly journals Gastric outlet obstruction secondary to peptic ulcer disease, previously misdiagnosed as idiopathic hypertrophic pyloric stenosis in a 16-year-old girl: a case report

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Yves Alain Notue ◽  
Ulrich Igor Mbessoh ◽  
Tim Fabrice Tientcheu ◽  
Boniface Moifo ◽  
Alain Chichom Mefire
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Pyloric Stenosis ◽  
Gastric Outlet Obstruction ◽  
Hypertrophic Pyloric Stenosis ◽  
Outlet Obstruction ◽  
Clinical Event ◽  
Distal Stomach ◽  
Ulcer Disease ◽  
Aetiological Diagnosis

Abstract Gastric outlet obstruction encompasses a broad spectrum of conditions characterized by complete or incomplete obstruction of the distal stomach, which interrupts gastric emptying and prevents the passage of gastric contents beyond the proximal duodenum. Idiopathic hypertrophic pyloric stenosis is the most common cause with an incidence of 1.5–3 per 1000 live births. However, it is excluded; other causes in children such as peptic ulcer disease are relatively rare. We report a case of an acquired gastric outlet obstruction due to peptic ulcer disease, previously misdiagnosed as idiopathic hypertrophic pyloric stenosis in a 16-year-old girl. Beyond the rarity of this clinical event, this case highlights the challenges of the aetiological diagnosis of gastric outlet obstruction with subsequent therapeutic issues, and is the first documented case in Cameroon.

scholarly journals Pyloric Atresia- A Case Report

1970 ◽  
Vol 33 (1) ◽  
pp. 35-36 ◽  
Author(s):  
A Hanif ◽  
K Hasina ◽  
K Hassan ◽  
ASM Hasanuzzaman ◽  
N Islam ◽  
...  
Keyword(s):  
Case Report ◽  
Child Health ◽  
Live Birth ◽  
Gastric Outlet Obstruction ◽  
Hypertrophic Pyloric Stenosis ◽  
Outlet Obstruction ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Pyloric Atresia ◽  
Complete Obstruction ◽  
Common Cause

Infantile hypertrophic pyloric stenosis (IHPS) is a common cause of gastric outlet obstruction in infant. The prevalence of IHPS ranges from 1.5 to 4.0 in 1000 live birth. But the incidence of IHPS has been increasing approximately from 1.5 to 4.0 in 1000 live birth to 1:150. Though pyloric atresia is a very uncommon cause of gastric outlet obstruction in infant but atresia in this region occurs in the form of web, membrane/diaphragm or rarely solid cord. Membrane/ diaphragm may be single or double and may be perforated or imperforated. If the size of perforation is less than 10 mm, it causes complete obstruction. We report the presentation and management of such a child. DOI: 10.3329/bjch.v33i1.5674Bangladesh Journal of Child Health 2009; Vol.33(1): 35-36

scholarly journals Infantile Hypertrophic Pyloric Stenosis - Experiences of 77 Cases

1970 ◽  
Vol 6 (1) ◽  
pp. 2-4
Author(s):  
AC Paul ◽  
MJ Alam ◽  
MK Hassan ◽  
MA Hannan ◽  
NK Das ◽  
...  
Keyword(s):  
Local Anesthesia ◽  
Pyloric Stenosis ◽  
Hypertrophic Pyloric Stenosis ◽  
Barium Meal ◽  
Outlet Obstruction ◽  
Oral Feeding ◽  
Electrolyte Imbalance ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Female Ratio ◽  
Mucosal Perforation

Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of gastric outlet obstruction in infants which needs surgical treatment. The aim of this study was to review the management of IHPS in our hospital to compare with other developed centers. This is a prospective analytical study carried out in the Department of Pediatric Surgery, Faridpur Medical College Hospital and Dr. Zahed Children Hospital at Faridpur, during the period of May 2002 to October 2010. Total 77 patients were treated by Ramstedt's pyloromyotomy after proper diagnosis and resuscitation. The male to female ratio was 10:1. Most of the patients presented to us within 40 days of age (90%).Younger one was 15 days and elder one was 69 days. In all cases diagnosis were done on clinical basis. The diagnosis is confirmed by barium meal x-ray in 71 cases and sonogram in 15 cases. Serum electrolytes were not estimated in all patients. There was moderate to severe dehydration in more than 60% cases. 71 cases were operated under general anesthesia and 06 cases were operated with local anesthesia. There was one postoperative death on 4th post-operative day. Oral feeding started after 8 to 10 hours postoperatively in all cases. Mucosal perforation occurred in 1 case and that was recognized and treated conservatively without any ill effect. Superficial wound infection encountered in 3 cases. Early diagnosis, preoperative correction of dehydration and electrolyte imbalance and experiences of surgeons play important role for management of IHPS. Key words: IHPS; Pyloromyotomy; Dehydration; Local anesthesia; Mucosal perforation. DOI: 10.3329/fmcj.v6i1.7401 Faridpur Med. Coll. J. 2011;6(1): 02-04

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