Pyloric stenosis surgery: Difference between revisions

Jump to navigation Jump to search
No edit summary
 
(12 intermediate revisions by 2 users not shown)
Line 4: Line 4:


==Overview==
==Overview==
Infantile pyloric stenosis is typically managed with [[surgery]]. Ranstedt's extramuscular [[pyloromyotomy]] is the [[Gold standard (test)|gold standard]] of treatment.
Infantile pyloric stenosis is typically managed with [[surgery]]. Ranstedt's extramuscular [[pyloromyotomy]] is the [[Gold standard (test)|gold standard]] of treatment. After the surgery, once the [[stomach]] can empty into the [[duodenum]], feeding can be started. There is occasionally recurrence in the immediate post-operative period, but the condition generally has no long-term impact on the [[child]]'s future.


== Indications ==
== Indications ==
[[Surgery]] is the mainstay of treatment for infantile pyloric stenosis.
[[Surgery]] is the mainstay of treatment for infantile pyloric stenosis.<ref name="Sparrow1921">{{cite journal|last1=Sparrow|first1=Charles A.|title=Congenital Hypertrophic Pyloric Stenosis|journal=The Boston Medical and Surgical Journal|volume=185|issue=8|year=1921|pages=235–238|issn=0096-6762|doi=10.1056/NEJM192108251850805}}</ref>


==Surgery==
==Surgery==
[[Image:Pyloromyotomie.jpg|thumb|left||Pyloromyotomy scar (rather large) 30 hrs post-op in a 1 month-old baby]]
* Definitive treatment for infantile pyloric stenosis is with surgical [[pyloromyotomy]].<ref name="pmid8583327">{{cite journal| author=Greason KL, Thompson WR, Downey EC, Lo Sasso B| title=Laparoscopic pyloromyotomy for infantile hypertrophic pyloric stenosis: report of 11 cases. | journal=J Pediatr Surg | year= 1995 | volume= 30 | issue= 11 | pages= 1571-4 | pmid=8583327 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8583327  }} </ref><ref name="pmid1523050">{{cite journal| author=Levine D, Edwards DK| title=The olive on end: a useful variant of the "shoulder" sign in the barium X-ray diagnosis of idiopathic hypertrophic pyloric stenosis. | journal=Pediatr Radiol | year= 1992 | volume= 22 | issue= 4 | pages= 275-6 | pmid=1523050 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1523050  }} </ref>
* Definitive treatment for infantile pyloric stenosis is with surgical [[pyloromyotomy]]<ref name="pmid8583327">{{cite journal| author=Greason KL, Thompson WR, Downey EC, Lo Sasso B| title=Laparoscopic pyloromyotomy for infantile hypertrophic pyloric stenosis: report of 11 cases. | journal=J Pediatr Surg | year= 1995 | volume= 30 | issue= 11 | pages= 1571-4 | pmid=8583327 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8583327  }} </ref>. This is a relatively straightforward [[surgery]] that can be done through a single larger [[incision]] or [[Laparoscopic surgery|laparoscopically]] (through several tiny [[incision]]<nowiki/>s), depending on the [[surgeon]]'s experience and preference.
*This is a relatively straightforward [[surgery]] that can be done through a single larger [[incision]] or [[Laparoscopic surgery|laparoscopically]] (through several tiny [[incision]]*s), depending on the [[surgeon]]'s experience and preference.
* Ranstedt's extramuscular [[pyloromyotomy]] is the [[Gold standard (test)|gold standard]] of treatment<ref name="pmid26581339">{{cite journal| author=Chalya PL, Manyama M, Kayange NM, Mabula JB, Massenga A| title=Infantile hypertrophic pyloric stenosis at a tertiary care hospital in Tanzania: a surgical experience with 102 patients over a 5-year period. | journal=BMC Res Notes | year= 2015 | volume= 8 | issue=  | pages= 690 | pmid=26581339 | doi=10.1186/s13104-015-1660-4 | pmc=4652415 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26581339  }} </ref>.
* Ranstedt's extramuscular [[pyloromyotomy]] is the [[Gold standard (test)|gold standard]] of treatment.<ref name="pmid26581339">{{cite journal| author=Chalya PL, Manyama M, Kayange NM, Mabula JB, Massenga A| title=Infantile hypertrophic pyloric stenosis at a tertiary care hospital in Tanzania: a surgical experience with 102 patients over a 5-year period. | journal=BMC Res Notes | year= 2015 | volume= 8 | issue=  | pages= 690 | pmid=26581339 | doi=10.1186/s13104-015-1660-4 | pmc=4652415 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26581339  }} </ref>
* After the surgery,once the [[stomach]] can empty into the [[duodenum]], feeding can commence.
* After the surgery, once the [[stomach]] can empty into the [[duodenum]], feeding can be started.
* There is occasionally recurrence in the immediate post-operative period, but the condition generally has no long-term impact on the [[child]]'s future.
* There is occasionally recurrence in the immediate post-operative period, but the condition generally has no long-term impact on the [[child]]'s future.
 
<br>
 
{| align="left"
| {{#ev:youtube|hvfye6nokpQ|500}}
|}
[[File:Pyloric Stenosis surgery.png|500px|thumb|left|Ultrasonography showing pyloric stenosis nipple sign [https://commons.wikimedia.org/wiki/File%3APyloric_Stenosis.png source:By BruceBlaus (Own work) [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons]]]
<br style="clear:left" />


==References==
==References==
Line 24: Line 28:
{{WS}}
{{WS}}


[[Category:Surgery]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Surgery]]
[[Category:Disease]]
[[Category:Pediatrics]]
[[Category:Up-To-Date]]

Latest revision as of 21:54, 11 December 2017

Pyloric stenosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pyloric stenosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Pyloric stenosis surgery On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Pyloric stenosis surgery

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pyloric stenosis surgery

CDC on Pyloric stenosis surgery

Pyloric stenosis surgery in the news

Blogs on Pyloric stenosis surgery

Directions to Hospitals Treating Pyloric stenosis

Risk calculators and risk factors for Pyloric stenosis surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

Infantile pyloric stenosis is typically managed with surgery. Ranstedt's extramuscular pyloromyotomy is the gold standard of treatment. After the surgery, once the stomach can empty into the duodenum, feeding can be started. There is occasionally recurrence in the immediate post-operative period, but the condition generally has no long-term impact on the child's future.

Indications

Surgery is the mainstay of treatment for infantile pyloric stenosis.[1]

Surgery

  • Definitive treatment for infantile pyloric stenosis is with surgical pyloromyotomy.[2][3]
  • This is a relatively straightforward surgery that can be done through a single larger incision or laparoscopically (through several tiny incision*s), depending on the surgeon's experience and preference.
  • Ranstedt's extramuscular pyloromyotomy is the gold standard of treatment.[4]
  • After the surgery, once the stomach can empty into the duodenum, feeding can be started.
  • There is occasionally recurrence in the immediate post-operative period, but the condition generally has no long-term impact on the child's future.


hvfye6nokpQ|500}}
Ultrasonography showing pyloric stenosis nipple sign source:By BruceBlaus (Own work) [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0), via Wikimedia Commons]


References

  1. Sparrow, Charles A. (1921). "Congenital Hypertrophic Pyloric Stenosis". The Boston Medical and Surgical Journal. 185 (8): 235–238. doi:10.1056/NEJM192108251850805. ISSN 0096-6762.
  2. Greason KL, Thompson WR, Downey EC, Lo Sasso B (1995). "Laparoscopic pyloromyotomy for infantile hypertrophic pyloric stenosis: report of 11 cases". J Pediatr Surg. 30 (11): 1571–4. PMID 8583327.
  3. Levine D, Edwards DK (1992). "The olive on end: a useful variant of the "shoulder" sign in the barium X-ray diagnosis of idiopathic hypertrophic pyloric stenosis". Pediatr Radiol. 22 (4): 275–6. PMID 1523050.
  4. Chalya PL, Manyama M, Kayange NM, Mabula JB, Massenga A (2015). "Infantile hypertrophic pyloric stenosis at a tertiary care hospital in Tanzania: a surgical experience with 102 patients over a 5-year period". BMC Res Notes. 8: 690. doi:10.1186/s13104-015-1660-4. PMC 4652415. PMID 26581339.

Template:WH Template:WS