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pyloric stenosis [keywords]
- Unusual presentations of eosinophilic gastroenteritis: Two case reports. [JOURNAL ARTICLE]
- Turk J Gastroenterol 2014 Jun; 25(3):323-329.
Eosinophilic gastroenteritis is a rare disease that is characterized by eosinophil infiltration in one or multiple segments of the gastrointestinal tract. The etiology of this condition remains unknown. Eosinophilic gastroenteritis has heterogeneous clinical manifestations that depend upon the location and depth of infiltration in the gastrointestinal tract, and eosinophilia may or may not be present. This article reports two cases of eosinophilic gastroenteritis. The first is that of a 49-year-old woman with abdominal pain, ascites, eosinophilia, and a history of asthma. The second case is that of a 69-year-old male with a history of loss of appetite, belching, postprandial fullness, heartburn, and a 5-kilogram weight loss over a period of 9 months; ultimately, the patient was diagnosed with a gastric outlet obstruction due to pyloric stenosis. The rare character of eosinophilic gastroenteritis and its varied clinical presentations often lead to delayed diagnoses and complications. Case reports may help to disseminate knowledge about the disease, thereby increasing the likelihood of early diagnosis and intervention to prevent complications.
- Laparoscopic gastric resection with natural orifice specimen extraction for postulcer pyloric stenosis. [Journal Article]
- Wideochir Inne Tech Malo Inwazyjne 2014 Jun; 9(2):282-5.
Although natural orifice specimen extraction is now relatively widely performed, there have been no reports on gastric resection with specimen extraction through the transgastric route for peptic ulcer disease. A hybrid technique of the laparoscopic and endoscopic approach is presented in the case of a 58-year old male patient. Preoperative gastric fibroscopy showed postulcer pyloric and antral stenosis. Laparoscopic exploration confirmed gastric enlargement. Laparoscopic two-thirds gastrectomy was performed. The staple line suture of the residual stomach was excised and the specimen was extracted through the esophagus and mouth with a gastroscope. Finally, the residual stomach was closed again using linear endostaplers. Reconstruction was performed according to the Roux-en-Y method. Gastric resection using natural orifice specimen extraction (NOSE) may be a feasible operative procedure. The NOSE with the combination of standard laparoscopy and specimen extraction through a natural orifice can be considered as a bridge to natural orifice translumenal endoscopic surgery.
- Maternal and pregnancy characteristics and risk of infantile hypertrophic pyloric stenosis. [Journal Article]
- J Pediatr Surg 2014 Aug; 49(8):1226-31.
The incidence of infantile hypertrophic pyloric stenosis (IHPS) in Sweden decreased dramatically during the 1990s. The aim of the study was to examine IHPS risk factors and the possible change in them as the incidence declined.This is a case-control study including 3608 surgically treated IHPS cases and 17588 matched controls during 1973-2008. Cases were identified in the Swedish National Patient Register and data on possible risk factors were collected from the Swedish Medical Birth Register. The association between study variables and IHPS was analyzed using conditional logistic regression for the whole study period and separately for periods with high and low IHPS incidences.Prematurity (OR, 2.54; 95% CI, 2.06-3.14), caesarean delivery (OR, 1.67; 95% CI, 1.51-1.86), maternal smoking (OR, 1.82; 95% CI, 1.53-2.16), and young maternal age (< 20yrs) (OR, 1.42; 95% CI, 1.17-1.73) were associated with an increased IHPS risk. Birth order 2 (OR, 0.78; 95% CI, 0.71-0.85) or more was associated with a lower IHPS risk. ORs for smoking increased at low incidence rate.We report caesarean section, prematurity, primiparity, young maternal age, and smoking as significant IHPS risk factors. The impact of smoking was higher during periods with a low incidence.
- Pyloric stenosis and macrolides. [Journal Article]
- J Paediatr Child Health 2014 Aug; 50(8):653-4.
- [Minimally invasive surgery in newborns weighting less than 2,500 g.] [JOURNAL ARTICLE]
- Rev Chil Pediatr 2014 Feb; 85(1):64-67.
Newborns (NB) represent a surgical challenge for the surgeon due to their physiological characteristics and reduced surgical spaces. During the last decade, minimally invasive surgery (MIS) has been adopted as a treatment for this group of patients. Objective: To report our experiences of MIS on NB weighing less than 2,500 grams. Patients and Method: A retrospective descriptive study was conducted analyzing the records of newborns weighing less than 2,500 g and subjected to MIS between April, 2009 and 2012. No patients were excluded. Results: 25 newborns participated on this study; among the treated conditions, congenital diaphragmatic hernia (1), Esophageal Atresia (4 complete repairs and 2 fistula ligation), duodenal obstruction (7), Gastroesophageal reflux disease (6 Nissen procedures, 4 including gastrostomy), Laparoscopic gastrostomy (2) Intestinal obstruction (two bowel resections, end to end anastomosis), and Hypertrophic pyloric stenosis (1). The average weight was 1,920 g (1,300-2,490 g) and 10 of the infants were preterm newborns. 3 mm instruments were used, 5 mm optic 30°. Neither intraoperative complications nor conversions were observed. A patient with tracheoesophageal atresia presented a fistula at the site of anastomosis with spontaneous resolution. Conclusions: MIS has revolutionized surgery, resulting in less intestinal adhesions, postoperative pain, shorter hospital stays and better aesthetic results. Due to the availability of smaller size materials, these procedures could be performed safely.
- Factors associated with the outcomes of endoscopic submucosal dissection in pyloric neoplasms. [JOURNAL ARTICLE]
- Gastrointest Endosc 2014 Jul 23.
Pyloric neoplasms are one of the most technically difficult lesions to remove by endoscopic submucosal dissection (ESD).To evaluate the therapeutic outcomes of ESD in pyloric neoplasms according to clinicopathologic characteristics and to assess predictive factors for incomplete resection.A retrospective, single-center study.A total of 110 cases of pyloric adenomas and early cancers treated with ESD from January 2007 to May 2013 were included.ESD procedures with or without retroflexion maneuver were used in all qualifying cases.Therapeutic outcomes of ESD and procedure-related adverse events.Complete resection rates differed significantly in relation to location (pylorus vs pylorus with duodenal extension, 79% vs 58%), directional distribution (upper hemisphere vs lower hemisphere of the pylorus, 67% vs 90%), tumor size (≤ 10 mm vs > 10 mm, 84% vs 67%), and circumferential extent of pyloric mucosal resection (≤ 1/2 vs > 1/2, 92% vs 62%). On multivariate analysis, tumor location (pylorus with duodenal extension; odds ratio 5.747), hemispheric distribution (upper hemisphere; odds ratio 4.906), and circumferential extent of resection (> 1/2; odds ratio 3.960) were independent factors associated with incomplete resection. The rates of procedure-related bleeding, stenosis, and perforation were 8%, 1%, and 1%, respectively; none of the adverse events required surgical intervention.Single-center, retrospective study.ESD is a safe, effective, and feasible treatment for pyloric neoplasms. However, the complete resection rate decreases for tumors that have duodenal extension, are located in the upper hemisphere, and have large circumferential extent of resection.
- Hypertrophic Pyloric Stenosis developing In a Patient Operated for Patent Urachus - A Case Report. [Journal Article]
- APSP J Case Rep 2014 May; 5(2):20.
A neonate with patent urachus (PU) who later developed hypertrophic pyloric stenosis (HPS) is being reported. The newborn was first operated for PU; post-operatively he developed persistent vomiting and radiological workup confirmed HPS. Pyloromyotomy was performed with an uneventful recovery.
- Acquired nonspecific cicatrizing inflammation causing pyloric stricture and gastric outlet obstruction in infancy: is it Jodhpur disease? [Case Reports, Journal Article]
- Trop Gastroenterol 2013 Oct-Dec; 34(4):274-7.