Pyloric stenosis surgery: Difference between revisions
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==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 == | |||
[[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== | ||
* 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> | |||
*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. | |||
* 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]] | * 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 be started. | ||
* After the surgery,once the [[stomach]] can empty into the [[duodenum]], feeding can | |||
* 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. | ||
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[[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]]] | |||
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==References== | ==References== | ||
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{{WS}} | {{WS}} | ||
[[Category:Surgery]] | |||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category: | [[Category:Disease]] | ||
[[Category:Pediatrics]] | |||
[[Category:Up-To-Date]] | |||
Latest revision as of 21:54, 11 December 2017
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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.
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References
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.