Pyloric Stenosis

Balint, John A.; Spence, M. P.

doi:10.1136/bmj.1.5126.890

Cited by 25 publications

(12 citation statements)

References 3 publications

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“…The clinical criteria upon which a diagnosis of pyloric stenosis is made are well known (Balint and Spence, 1959), but the signs and symptoms of gastric stasis are less certain (Roth et al, 1962;Hildebrand and Thomson, 1964).…”

Section: Assessment Of Gastric Emptyingmentioning

confidence: 99%

“…Experimentally Milton (1962) has shown that if the outlet of a canine Heidenhain pouch is obstructed, it rapidly loses its ability to respond to histamine stimulation. The diagnosis of pyloric stenosis is not always easy, sometimes being made for the first time in the operating theatre (Balint and Spence, 1959). The diagnosis of gastric stasis can be even more difficult.…”

Section: Normal Patientsmentioning

confidence: 99%

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Effects of gastric surgery upon gastric emptying in cases of peptic ulceration.

Buckler¹

1967

Gut

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Section: Assessment Of Gastric Emptyingmentioning

confidence: 99%

Section: Normal Patientsmentioning

confidence: 99%

Effects of gastric surgery upon gastric emptying in cases of peptic ulceration.

Buckler¹

1967

Gut

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“…5,6 These observations reveal that the incidence of gastric outlet obstruction secondary to chronic duodenal ulcer could have reduced while that of malignancy has relatively gone up. In present study age of occurrence ranged from 20 to 73 years.…”

Section: Discussionmentioning

confidence: 77%

Gastric outlet obstruction: clinical presentations and its surgical management

2018

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Background: Gastric outlet obstruction (GOO) mechanically impedes gastric emptying, normal emptying of the stomach. It is a diagnostic and therapeutic challenge for general surgeons in their daily practice. This paper highlights the etiology, clinical presentation and treatment outcome of GOO.Methods: A Prospective study was conducted on patients with GOO treated at Rajarajeswari medical college and hospital, Bangalore during September 2015 to august 2017. Data was tabulated and analyzed using descriptive statistical methodology.Results: Carcinoma stomach with antral growth and cicatrized duodenal ulcer (both 41.5%) were the most common cause of gastric outlet obstruction. Male were more affected than females (2.5:1). Most common symptom was vomiting and abdominal pain (noted among all), followed by loss of appetite (83%) and loss of weight (82.35%). 94.1% patients of Cicatrized duodenal ulcer underwent truncal vagotomy with posterior gastrojejunostomy and 5.9% underwent truncal vagotomy with antrectomy. 58.8% patients of carcinoma stomach, underwent distal gastrectomy with ante-colic Roux-en-Y gastro- jejunostomy, 12.1% patients underwent subtotal gastrectomy with ante-colic and Roux-en-Y gastro jejunostomy and 4.8% patients underwent palliative gastrojejunostomy. In corrosive antral stricture Billroth I gastrectomy was done. Patients of pancreatic malignancy underwent palliative anterior gastrojejunostomy and pseudo- pancreatic cyst was treated by cystojejunostomy. The average hospital stay was 10-14 days and an overall mortality of 5.8% for malignant patients was noted.Conclusions: Study concludes that gastric outlet obstruction is an important and a common surgical condition in tertiary hospital. Malignancy and benign cicatrized duodenal ulcer being the most common cause.

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“…Multiple criteria have been used to select patients with significant gastric outlet obstruction because pyloric or duodenal stenosis presents with different symptoms (Balint and Spence, 1959). A modification of the criteria used by Balint and Spence has been used.…”

Section: Patientsmentioning

confidence: 99%

Gastric emptying after treatment of stenosis secondary to duodenal ulceration by proximal gastric vagotomy and duodenoplasty or pyloric dilatation.

White¹,

Harding²,

Keighley³

et al. 1978

Gut

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SUMMARY A consecutive series of 12 patients with stenosis secondary to duodenal ulceration were treated by proximal gastric vagotomy (PGV) and duodenoplasty or PGV and dilatation of the stenosis. Three months after operation the rate and pattern of gastric emptying of a solid meal was measured in each patient and compared with 18 patients with uncomplicated duodenal ulcer treated by PGV alone. Two patients developed gastric stasis in the early postoperative period which resolved with medical treatment. All patients were asymptomatic and were eating normally three months after operation. There was no significant difference in the rate of gastric emptying postoperatively between the patients who had stenosis and those who had uncomplicated duodenal ulcers. These results indicate that despite early postoperative difficulties in some patients pyloric dilatation or duodenoplasty with PGV are both effective treatments for stenosis due to duodenal ulceration.The superior early results of proximal gastric vagotomy (PGV) compared with other operations for duodenal ulcer are due to the preservation of an intact and innervated pyloric antrum (Johnston and Wilkinson, 1970;Clarke and Williams, 1972;Amdrup et al., 1974). However, gastric outlet obstruction is usually considered a contraindication to PGV unless it is combined with a drainage procedure. Pyloric or duodenal stenosis due to duodenal ulceration is usually treated by procedures that destroy the pylorus or bypass the pyloric antrum and are therefore likely to produce dumping, diarrhoea and bile vomiting (Wastell, 1969;Goligher, 1970).Johnston suggested that patients with duodenal ulcer complicated by stenosis should be treated by PGV and dilatation of the stenosis (Johnston et al., 1973). He also reported that the symptomatic results in patients with pyloric stenosis were better after PGV and dilatation than after truncal vagotomy and drainage (McMahon et al., 1976). Duodenoplasty is an alternative method of treating the stenosis without destroying the pylorus. The symptomatic results of PGV and duodenoplasty in 25 patients with pyloric stenosis were indistinguishable from those in patients with uncomplicated ulcer treated by PGV alone

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Pyloric Stenosis

Cited by 25 publications

References 3 publications

Effects of gastric surgery upon gastric emptying in cases of peptic ulceration.

Effects of gastric surgery upon gastric emptying in cases of peptic ulceration.

Gastric outlet obstruction: clinical presentations and its surgical management

Gastric emptying after treatment of stenosis secondary to duodenal ulceration by proximal gastric vagotomy and duodenoplasty or pyloric dilatation.

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