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Pyloric stenosis is a narrowing of the opening from the stomach to the first part of the small intestine (the pylorus). [1] Symptoms include projectile vomiting without the presence of bile . [ 1 ] This most often occurs after the baby is fed. [ 1 ]
The pyloromyotomy is primarily indicated by the presence of hypertrophic pyloric stenosis. [5] [1] Hypertrophic Pyloric stenosis is a gastrointestinal tract defect, most commonly seen in young children, typically in the first few months of life, caused by enlargement of the tissue in the pyloric muscle.
In children, congenital pyloric stenosis / congenital hypertrophic pyloric stenosis may be a cause. A pancreatic pseudocyst can cause gastric compression. Pyloric mucosal diaphragm could be a rare cause. Malignant Tumours of the stomach, including adenocarcinoma (and its linitis plastica variant), lymphoma, and gastrointestinal stromal tumours
The pyloric tit sign is a radiological finding observed during barium studies in cases of hypertrophic pyloric stenosis. [1] It appears as an outpouching on the lesser curvature of the stomach, just proximal to the impression created by the hypertrophied pyloric muscle.
In infants with hypertrophic pyloric stenosis, the pylorus is narrowed and the radio-opaque material will take on the appearance of a thin string as it passes through this narrowed channel. Often, there are several of these strings seen (called the "railroad track sign").
The recommended treatment consists of oral erythromycin base or ethylsuccinate 50 mg/kg/day divided into four doses daily for two weeks while monitoring for symptoms of infantile hypertrophic pyloric stenosis (IHPS) in infants less than 6 weeks old. [12]
Infantile hypertrophic pyloric stenosis was first fully described by Harald Hirschsprung in 1888. [4] Initially surgeons were reluctant to advise surgical intervention in these cases, even though mortality from the condition was high, as the mortality rate from surgery was also very high. [2]
Neonatal jaundice may develop in the presence of sepsis, hypoxia, hypoglycemia, hypothyroidism, hypertrophic pyloric stenosis, galactosemia, fructosemia, etc. Hyperbilirubinemia of the unconjugated type may be caused by: increased production hemolysis (e.g., hemolytic disease of the newborn, hereditary spherocytosis, sickle cell disease)