Adult idiopathic hypertrophic pyloric stenosis

Lin, Hsien-Ping; Lin, Yu-Chieh; Kuo, Chen‐Yun

doi:10.1016/j.jfma.2012.07.001

Cited by 11 publications

(22 citation statements)

References 14 publications

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“…The clinical symptoms of adult IHPS are similar to the clinical symptoms of gastric outlet obstruction induced by other causes including epigastralgia, easy satiety, and postprandial nausea or vomiting 2 . The exact etiology of AHPS is unclear, and it is usually difficult to diagnose AHPS before surgical resection 2 . In patients with AHPS, gastrography usually shows an elongated and narrow pyloric canal, and delayed gastric emptying due to pyloric stenosis 2,3 .…”

Section: Discussionmentioning

confidence: 98%

“…Hypertrophy of the pyloric muscle is milder in patients with the second type of AHPS than in patients with the primary types of AHPS, and patients with the second type of AHPS often do not have any symptoms 1 . The clinical symptoms of adult IHPS are similar to the clinical symptoms of gastric outlet obstruction induced by other causes including epigastralgia, easy satiety, and postprandial nausea or vomiting 2 . The exact etiology of AHPS is unclear, and it is usually difficult to diagnose AHPS before surgical resection 2 .…”

Section: Discussionmentioning

confidence: 98%

“…The most common type of AHPS is due to peptic ulcer disease, malignancy, and certain inflammatory diseases 1 . However, it is usually difficult to make the diagnosis of AHPS due to the lack of specificity of clinical and laboratory abnormalities; therefore, surgical resection is often performed to establish the diagnosis and provide treatment 2 . Here, we report a rare case of AHPS in an adult woman with double pylorus formation which led to improvement of her symptoms.…”

Section: Introductionmentioning

confidence: 96%

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Adult hypertrophic pyloric stenosis that improved by spontaneous double channel pylorus formation

et al. 2020

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Adult hypertrophic pyloric stenosis (AHPS) is a rare disease and presents as pyloric obstruction. Double pylorus is also a rare condition due to a gastroduodenal fistula connecting from the gastric antrum to the duodenum. A 42‐year‐old woman without a history of vomiting in infancy presented with postprandial abdominal distension and repeated vomiting. Abdominal computed tomography showed gastric dilatation and wall thickening of the distal stomach. Endoscopy and contrast gastrography revealed gastric outlet obstruction due to stenosis and an ulcer in the antral and pyloric region. Endoscopic ultrasonography revealed circumferential thickening of the muscularis propria layer of the pylorus. Her symptoms improved with treatment consisting of drainage, fasting, and a proton pump inhibitor. Two weeks after onset, follow‐up endoscopy revealed a healing ulcer and double channel pylorus. Based on her clinical course and findings of clinical images, she was diagnosed with gastric outlet obstruction due to AHPS that was improved by double channel pylorus formation. In conclusion, AHPS that was improved by double channel pylorus formation is an extremely rare condition, and we should be aware of this disease entity.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 96%

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Adult hypertrophic pyloric stenosis that improved by spontaneous double channel pylorus formation

et al. 2020

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“…The majority of researchers believe it to be the persistence of the mild juvenile form of HPS [11–13], which is further strengthened by the fact that both infantile and adult IHPS have similar histological and anatomical changes [14]. However, it still seems unclear as to the reason of the prolonged asymptomatic period until the age of 30–60 years.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, there is no evidence of one surgical technique being superior to another. Further research on AIHPS is warranted before a method can be finalized as the standard of care [10,13,21]. …”

Section: Discussionmentioning

confidence: 99%

Adult idiopathic hypertrophic pyloric stenosis - a common presentation with an uncommon diagnosis

Hassan¹,

Mubarik²,

Muddassir³

et al. 2018

Journal of Community Hospital Internal Medicine Perspectives

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Background and Objectives: Adult Idiopathic hypertrophic pyloric stenosis (AIHPS) is a rare but well-defined entity in adults with only 200-300 cases reported so far in the literature.We describe a case of AIHPS and the relevant literature review.Methods and Results: The patient presented with acute onset upper abdominal pain associated with nausea, vomiting, foul-smelling black tarry stools, and anorexia. On the Esophagogastroduodenoscopy (EGD), pylorus demonstrated a unique “cervix sign.” The patient had multiple endoscopic dilations with minimal relief. She then underwent a distal partial gastrectomy with a Billroth 1 gastroduodenostomy with considerable improvement in her symptoms on follow up.Conclusion: Adult Idiopathic hypertrophic pyloric stenosis (AIHPS) is a rare disease which is also underreported due to a difficulty in diagnosis. The most common symptoms of AIHPS are postprandial nausea, vomiting, early satiety, and epigastric pain as seen in our patient. Endoscopy usually shows ?Cervix sign? a unique sign showing a fixed, markedly narrowed pylorus with a smooth border. Multiple treatments have been proposed for AIHPS, including endoscopic dilation, pyloromyotomy with or without pyloroplasty, gastrectomy with a Billroth 1 gastroduodenostomy. Currently, there is no evidence of one surgical technique being superior to another. Further research needs to be done on AIHPS before one technique can be standardized as the standard of care.

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