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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
Myotomies may be performed using open, laparoscopic, or endoscopic techniques, depending on the location and condition being treated. Common types include the Heller myotomy, used to treat esophageal achalasia, and pyloromyotomy, commonly performed in infants with pyloric stenosis.
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").
Newborns present with bilious or non-bilous vomiting (depending on where in the duodenum the obstruction is) within the first 24 to 48 hours after birth, typically after their first oral feeding. Radiography shows a distended stomach and distended duodenum, which are separated by the pyloric valve, a finding described as the double-bubble sign.
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 .
Pyloric stenosis (in babies, this typically causes a very forceful "projectile vomiting" and is an indication for urgent surgery) Bowel obstruction; Overeating (stomach too full) Acute abdomen and/or peritonitis; Ileus; Food allergies (often in conjunction with hives or swelling) Cholecystitis, pancreatitis, appendicitis, hepatitis; Food poisoning