Pyloric Narrowing with Increased Fibrous Tissue of the Mucosa in an Infant.

Kato, Seiichi; Konnai, Ikuo; Harada, Yoshinori; Komatsu, Keiko; Nakagawa, Hiroshi

doi:10.1620/tjem.163.233

Cited by 3 publications

(1 citation statement)

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“…The cause of the fibrosis around the pylorus could not be determined. Kato et al [23] found one infant with GOO caused by non-specific inflammation with increased fibrous tissue of the mucosa in the pylorus, and they postulated that antral/pyloric mucosal inflammation might be the cause of such pyloric narrowing and then led to nonbilious vomiting. Our case was successfully treated by H-M pyloroplasty.…”

Section: Discussionmentioning

confidence: 99%

Rare causes of gastric outlet obstruction in children

Feng

et al. 2005

Ped Surgery Int

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Gastric outlet obstruction (GOO) presenting beyond the newborn period is a relatively rare condition, when infantile hypertrophic pyloric stenosis (IHPS) is excluded. This report describes the clinical features, evaluation and management of 18 patients with GOO which was not caused by IHPS. The sex, age, and main presenting features were recorded on admission. Hemoglobin estimation, serum chemistry and blood gas analysis were also assessed in these patients. The diagnosis was confirmed with gastrointestinal barium, B ultrasound, gastroscopy, or at surgery. Some of them underwent gastroscopy with biopsy sampling for rapid urease test or histologic examination with Giemsa stains for Helicobacter pylori. Thirteen patients had peptic ulcer disease, of which six were successfully treated with medications. While the other seven needed operative management which included Heineke-Mikulicz pyloroplasty, gastroduodenostomy or gastrojejunostomy, respectively. All the patients who had Heineke-Mikulicz pyloroplasty or gastrojejunostomy developed bile reflux gastritis that could be alleviated with omeprazol. None of the patients developed dumping syndrome, failing to thrive, or anemia. Three children with antral diaphragm recovered without any complications by diaphragm excision with Heineke-Mikulicz pyloroplasty. The pylorus was compressed by fibrotic band in one 30-month boy, and he recovered uneventfully with Heineke-Mikulicz pyloroplasty during 10-year follow-up. Gastric outlet obstruction secondary to ingestion of sulfuric acid was noted in one patient, and he was successfully treated with gastroduodenostomy. Our data suggests that the satisfactory results could be expected in children with GOO with different therapeutic modalities based on the specific cause and degree of obstruction.

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Section: Discussionmentioning

confidence: 99%