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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.
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.
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.
Barium X-ray examinations are useful tools for the study of appearance and function of the parts of the gastrointestinal tract. They are used to diagnose and monitor esophageal reflux, dysphagia, hiatus hernia, strictures, diverticula, pyloric stenosis, gastritis, enteritis, volvulus, varices, ulcers, tumors, and gastrointestinal dysmotility, as well as to detect foreign bodies.
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
Superior mesenteric artery compressing the duodenum, featuring the superior mesenteric artery syndrome. Superior mesenteric artery (SMA) syndrome is a gastro-vascular disorder in which the third and final portion of the duodenum is compressed between the abdominal aorta (AA) and the overlying superior mesenteric artery.
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It may be seen in Crohn's disease, hypertrophic pyloric stenosis, carcinoid tumor and colon cancer. In people with Crohn's Disease, the string sign is caused by incomplete filling of the intestinal lumen, which results from irritability and spasm associated with severe ulceration.
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