Adult Pyloric Obstruction Due to a Mucosal Diaphragm

Chamberlain, Digby; Addison, N. V.

doi:10.1136/bmj.2.5163.1381

Cited by 17 publications

(3 citation statements)

References 11 publications

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“…6 Two cases have been reported in which the cause was found to be due to a "mucosal diaphragm." 7 In the uncommon primary (idiopathic) form to which our case would belong, there is a total or segmental hypertrophy of the smooth muscle without any identifiable underlying disease. 2 8 Diagnostic clues are nonspecific but an endoscopic feature (the "cervix sign") has been described which may be a pointer to the diagnosis.…”

Section: Discussionmentioning

confidence: 80%

Adult hypertrophic pyloric stenosis: case report and review.

Roggen

Krieken

1998

J Clin Pathol

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A case of adult hypertrophic pyloric stenosis presented in an older female with no apparent predisposing factors which might be likely to precipitate the condition. There was a history of chronic dyspepsia and occasional episodes of vomiting. No contributory medical history was identified. Barium swallow and follow through showed a markedly reduced emptying time of the stomach. A partial gastrectomy was eventually done and on histopathological examination a diagnosis of adult hypertrophic pyloric stenosis was made.

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Section: Discussionmentioning

confidence: 80%

Adult hypertrophic pyloric stenosis: case report and review.

Roggen

Krieken

1998

J Clin Pathol

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“…The secondary type usually demonstrates a predominantly localized replacement by fibrous tissue, with little or no smooth muscle hypertrophy. Other rare reported causes are postinflammatory complication in Crohn's disease [ 17 ] and mucosal diaphragm [ 18 ]. Stress ulceration at the pylorus has been proposed as the cause of infantile hypertrophic pyloric stenosis [ 19 ], although it does not seem to have a role in the adult form.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Hypertrophic Pyloric Stenosis in an Adult, a Potential Mimic of Gastric Carcinoma

Zarineh

Leon

Silverman

2010

Pathology Research International

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Primary or idiopathic hypertrophy of the pyloric muscle (IHPM) is a rare entity with uncertain pathogenesis which both clinically and pathologically mimics gastric cancer. We present a rare late-occurring case of IHPM in a 71-year-old Caucasian man with no apparent predisposing factor. Imaging studies demonstrated gastric distension with air fluid levels and no evidence of extrinsic compression. At upper endoscopy, massive gastric distension and no evidence of any ulcer or other mucosal defects were observed. Microscopically, marked hypertrophy of muscularis mucosa with smooth muscle cells arranged in whorls and fascicles was present which gradually transitioned to normal areas. The muscle fibers stained with smooth muscle actin and trichrome stain highlighted fibrosis between the muscle fibers. Although uncommon, IHPM can clinically and histologically mimic other proliferations in the gastric wall, such as gastrointestinal stromal tumor or a spindle cell neoplasm. The recent advances in understanding the pathogenesis of IHPM are discussed.

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“…5,9 One reported cases was due to crohns' disease and one due to mucosal diaphragm. 10,11 We classify our case to be of a primary diffuse form without a proximal lesion and segmental smooth muscle hypertrophy due to peptic ulceration and no fibrosis. Differential diagnosis on the basis of diffuse circumferential morphology may be a stromal tumor and in our case other causes are less likely.…”

Section: Discussionmentioning

confidence: 99%