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Pyloric stenosis as seen on ultrasound in a 6-week-old [13] Diagnosis is via a careful history and physical examination, often supplemented by radiographic imaging studies. Pyloric stenosis should be suspected in any infant with severe vomiting. On physical exam, palpation of the abdomen may reveal a mass in the epigastrium.
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
nasogastric suction, surgery (duodenoduodenostomy) Duodenal atresia is the congenital absence or complete closure of a portion of the lumen of the duodenum . It causes increased levels of amniotic fluid during pregnancy ( polyhydramnios ) and intestinal obstruction in newborn babies.
Gastrectomy, gastric bypass surgery, diabetes, esophageal surgery, absent or inefficient pyloric sphincter, pyloric stenosis Dumping syndrome occurs when food, especially sugar, moves too quickly from the stomach to the duodenum —the first part of the small intestine—in the upper gastrointestinal (GI) tract .
Surgery, consisting of excision of part of the lower stomach, also called antrectomy, is another option. [6] [16] Antrectomy is "the resection, or surgical removal, of a part of the stomach known as the antrum". [2] Laparoscopic surgery is possible in some cases, and as of 2003, was a "novel approach to treating watermelon stomach". [26]
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").
Retained gastric material greater than three hours after a meal will generate a splash sound and indicate the presence of a hollow viscus filled with both fluid and gas. An example would be a gastric outlet obstruction (GOO) due to pyloric stenosis, with abdominal succussion splash. [1]