Idiopathic pyloric stenosis
Dimitrios Manatakis, Maria Sioula
The Pan African Medical Journal. 2016;25:23. doi:10.11604/pamj.2016.25.23.10707

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Idiopathic pyloric stenosis

Cite this: The Pan African Medical Journal. 2016;25:23. doi:10.11604/pamj.2016.25.23.10707

Received: 11/09/2016 - Accepted: 16/09/2016 - Published: 27/09/2016

Key words: Pyloric stenosis idiopathic, adult

© Dimitrios Manatakis et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/25/23/full

Corresponding author: Dimitrios Manatakis, Department of Surgery, “Konstantopouleio” General Hospital, Nea Ionia, Athens, Greece (amiche75@gmail.com)


Idiopathic pyloric stenosis

Dimitrios Manatakis1,&, Maria Sioula1

 

1Department of Surgery, “Konstantopouleio” General Hospital, Nea Ionia, Athens, Greece

 

 

&Corresponding author
Dimitrios Manatakis, Department of Surgery, “Konstantopouleio” General Hospital, Nea Ionia, Athens, Greece

 

 

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Idiopathic pyloric stenosis in adults is a rare condition of unknown etiology, caused by hypertrophy and hyperplasia of the pyloric musculature with gastric outlet obstruction and delayed gastric emptying. It should be differentiated from the secondary form, caused by recurrent peptic ulcers, malignancy or hypertrophic gastritis. Symptoms include epigastric pain, early satiety and postprandial nausea and vomiting, however many cases remain asymptomatic for years. Although pyloroplasty is an acceptable option, distal gastric resection is the recommended approach, to avoid recurrence. We report the case of 44-year-old man who presented at the emergency department, with a 5-day history of protracted vomiting, abdominal pain and constipation. He appeared severely malnourished, complaining of malaise and generalized weakness. Clinical examination revealed hypotension (90/60 mmHg) and tachycardia (100 bpm), abdominal distention with hyper-resonance during percussion and diffuse tenderness on palpation. Other than leukocytosis (12,000/mcL), laboratory tests were within normal range and the nasogastric tube produced 200ml of clear, non-bilious fluid. CT scans showed a markedly dilated stomach (A), causing compression of the inferior vena cava and the solid organs of the upper abdomen (B,C). He was transferred to the operating theater for exploratory laparotomy, however he collapsed hemodynamically upon induction to anesthesia, and succumbed despite attempts to CPR.

 

 

Figure 1: idiopathic pyloric stenosis

 

 

 

 


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