ABSTRACT
La estenosis hipertrófica del píloro (EHP) es una patología quirúrgica común en la edad pediátrica. Apesar de ser una condición frecuente, su etiología aún no está claramente dilucidada. La presentación clínica corresponde a vómitos explosivos lácteos, no biliosos y en algunos casos oliva palpable en el abdomen u ondas peristálticas luego de ser alimentados. Si bien el manejo resolutivo de esta patología requiere la intervención del cirujano infantil, la sospecha inicial incluye al médico general y pediatra. Este artículo presenta una revisión de la literatura disponible sobre el tema.
Hypertrophic pyloric stenosis (EHP) is a common surgical pathology in children. Despite being a common condition, its etiology is not yet clearly known. The clinical presentation corresponds to milky, explosive and nonbilious threw up, and in some cases palpable olive in the abdomen or peristaltic waves after being fed. While surgical management of this condition requires the intervention of child surgeon, the initial suspicion includes the general physician and pediatrician. This article presents a review of the available literature on the subject.
Subject(s)
Humans , Male , Female , Infant , Pyloric Stenosis, Hypertrophic/diagnosis , Pyloric Stenosis, Hypertrophic/therapy , Diagnosis, Differential , Pyloric Stenosis, Hypertrophic/complications , Prognosis , Vomiting/etiologyABSTRACT
The most common cause of gastric outlet obstruction in neonates and infants is hypertrophic pyloric stenosis. Pyloric web as a cause of gastric outlet obstruction is relatively rare in children and presents with non bilious vomiting, abdominal pain and failure to thrive. The onset of symptoms is usually late with nonspecific symptoms like vomiting and failure to thrive that seems to be due to neuromuscular incoordination. Here we report a 3 year-old boy with prolonged fever, anorexia, and intractable postprandial non bilious vomiting and weight loss since 20 days prior to admission. Barium meal study revealed gastric outlet obstruction with a dilated stomach. The patient underwent laparotomy and pyloric web was confirmed as the cause of the symptoms and Heineke-Mikulicz pyloroplasty led to disappearing of the entire patient's problems
Subject(s)
Humans , Male , Pyloric Stenosis, Hypertrophic/complications , Child, Preschool , Gastric Outlet Obstruction/diagnosis , LaparotomySubject(s)
Age Factors , Child , Child, Preschool , Female , Humans , Infant , Intestinal Atresia/complications , Intestinal Obstruction/etiology , Intussusception/complications , Male , Postoperative Complications/surgery , Pyloric Stenosis, Hypertrophic/complications , Tissue Adhesions/complicationsABSTRACT
This study aimed to evaluate the effectiveness of oral atropine in the management of IHPS. Cases were diagnosed clinically and confirmed sonographically. Atropine was given orally from the outset at a dose of 0.18 mg/kg/day in eight divided doses, increased daily by 1/4th of the commencing dose till vomiting ceased. Ultrasonographic evaluation of pyloric muscle thickness and length was done at the commencement of treatment, after completion of treatment and at 3, 6, 9, 12 and 15 months follow up. Oral atropine was effective in 11/12 (91.06%) cases. Vomiting ceased in 14 to 21 days in all cases. One case required initial 7 days of i.v. treatment followed by 18 days oral treatment to stop vomiting. USG evidence of normalization of pylorus was observed in all these cases, 3-15 months after completion of treatment. We conclude that oral atropine proved to be a simple, effective, safe, very cheap and acceptable treatment option for IHPS.