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Acquired Hypertrophic Pyloric Stenosis
Adult Hypertrophic Pyloric Stenosis

Presentation

While this is present in only about half of infants, it has a relatively high positive predictive value for pyloric stenosis (PPV of 88% with pH >7.45, chloride 3).( 5 ) Some degree of biochemical derangement is almost always present when severe vomiting [rch.org.au]

Clinical symptoms, food vomiting and loss of weight, were present for several weeks before the diagnosis of NHPS was made. The diagnosis was peptic stenosis in 3 cases and has not been established in 3 cases. [wwww.unboundmedicine.com]

Confirm each diagnosis by consulting a section, organized by symptoms, that presents the full range of differential diagnoses and treatment options for each specific condition. [books.google.de]

As per our knowledge this is the first case report of prepyloric stricture presented as GOO. Conclusion There are several rare causes of GOO in children that may present with a variety of symptoms. [casesjournal.biomedcentral.com]

Nine children (age 3 mo to 17 years) presented with a history of late-onset primary GOO of unknown etiology[ 9 ]. [wjgnet.com]

Entire Body System

  • Weight Loss

    You should see a doctor if you have any of the following: Blood when you have a bowel movement Severe abdominal pain Heartburn not relieved by antacids Unintended weight loss Ongoing vomiting or diarrhea NIH: National Institute of Diabetes and Digestive [icdlist.com]

    The possible complications of Pyloric Stenosis are: Weight loss or problems with appropriate weight gain according to age: The child weighs much less than what is expected for a normal growing child Dehydration, which can be severe enough to cause multiple [dovemed.com]

    In addition the patient also complains of frequent pain in the upper part of the abdomen, early satiety, nausea, loss of appetite and weight loss. At times, non-projectile vomiting and jaundice may occur. [medindia.net]

    Severe or neglected cases can result in significant weight loss and failure to thrive. [ipeg.org]

    Fasting will lead to weight loss, using fasting for weight loss is considered dangerous. [wikivividly.com]

  • Weight Gain

    […] coffee-ground appearance is sometimes observed Patients are usually not ill-looking or febrile; the baby in the early stage of the disease remains hungry and sucks vigorously after episodes of vomiting Prolonged delay in diagnosis can lead to dehydration, poor weight [emedicine.medscape.com]

    The possible complications of Pyloric Stenosis are: Weight loss or problems with appropriate weight gain according to age: The child weighs much less than what is expected for a normal growing child Dehydration, which can be severe enough to cause multiple [dovemed.com]

    Three years later, no vomiting has been reported and M.K. has a normal weight gain. Discussion The condition described in 1887 by Hirschsprung has been subjected to many pathogenic hypotheses, none of which has been validated to date. [ncbi.nlm.nih.gov]

    Some infants present with poor feeding and weight loss but others demonstrate normal weight gain. [en.wikipedia.org]

  • Surgical Procedure

    In all cases of proved pyloric stenosis, after failure of medical and endoscopic treatment, a simple surgical procedure (pyloroplasty) associated with medical treatment seems to be effective. [wwww.unboundmedicine.com]

    Treatment Pyloric stenosis can be cured with a surgical procedure called a pyloromyotomy. In this operation, the surgeon makes an incision in the baby's abdomen. Then a small cut is made in the thickened muscle of the pylorus and it is spread apart. [medical-dictionary.thefreedictionary.com]

  • Short Stature

    Referrals are made to genetics clinics for a variety of reasons, including birth defects, developmental delay, autism, epilepsy, short stature, in the United States, physicians who practice clinical genetics are accredited by the American Board of Medical [wikivividly.com]

  • Swelling

    […] the ward, ensure infant's temperature is stable prior to transferring to open cot monitor infant's temperature hourly until stable routine post anaesthetic observations monitor wound and report abnormalities to surgeon observe for bleeding, redness, swelling [rch.org.au]

Gastrointestinal

  • Vomiting

    Clinical symptoms, food vomiting and loss of weight, were present for several weeks before the diagnosis of NHPS was made. The diagnosis was peptic stenosis in 3 cases and has not been established in 3 cases. [wwww.unboundmedicine.com]

    Signs and symptoms Features of the history in infants with hypertrophic pyloric stenosis are as follows: Typical presentation is onset of initially nonbloody, usually nonbilious vomiting at 4-8 weeks of age [1] Although vomiting may initially be infrequent [emedicine.medscape.com]

    […] in an Infant Case 46 516 Chapter 66 3YearOld Female with a 12Hour Onset of Abdominal Pain Vomiting and Fever of 385C Case 47 523 Chapter 67 4YearOld Boy with a Groin Mass Case 48 529 Chapter 68 2YearOld Boy with Gastrointestinal Bleeding Case 49 537 [books.google.de]

    The main symptom is vomiting after feedings. These episodes of vomiting usually get worse over time, happening more often and becoming more forceful (forceful vomiting is often called "projectile" vomiting). [medical-dictionary.thefreedictionary.com]

    The signs and symptoms of Pyloric Stenosis include the following: Projectile vomiting: Vomiting that occurs with great force, resulting in the vomitus being thrown to a great distance Poor feeding Burping Weight loss Dehydration that is often observed [dovemed.com]

  • Projectile Vomiting

    The patient experiences projectile vomiting of partially digested food after eating; the vomitus does not contain bile. [medindia.net]

    But, it usually presents within the first 3-4 weeks of life and is noticed by the classic sign of projectile vomiting In case of any signs of poor feeding, projectile vomiting with feedings, or weight loss, it is important to seek medical advice, as quickly [dovemed.com]

    The typical infant presents with nonbilious projectile vomiting and ... [weightssimpson.tk]

    The abnormal narrowing of the opening of the pylorus causes episodes of projectile vomiting. [medical-dictionary.thefreedictionary.com]

    over several days it becomes more predictable, occurring at nearly every feeding Vomiting intensity also increases until pathognomonic projectile vomiting ensues Slight hematemesis of either bright-red flecks or a coffee-ground appearance is sometimes [emedicine.medscape.com]

  • Bilious Vomiting

    This condition causes severe projectile non-bilious vomiting. It most often occurs in the first few months of life, when it may thus be more specifically labeled as infantile hypertrophic pyloric stenosis. [icd.codes]

    Bilious vomiting is infantile hypertrophic pyloric stenosis. Simple and complicated hypertrophic pyloric stenosis in the. Pediatric Gastrointestinal Conditions Flashcards Quizlet Learn more about Infantile Hypertrophic Pyloric Stenosis. [age-reaction.ml]

    In most cases, the typical projectile, non-bilious vomiting usually occurred between the age of 2 weeks and 8 weeks [2], [13]. [journals.plos.org]

    Observation N° 1 K.J, a 5-month old male infant and first born in a family of one was admitted on 28.09. 06 for early non bilious vomiting that had been lasting for 5 days. [ncbi.nlm.nih.gov]

    Infants with ongoing vomiting or gastric losses may need additional replacement. [rch.org.au]

  • Congenital Hypertrophic Pyloric Stenosis

    (hypertrophic) K31.1 ICD-10-CM Diagnosis Code K31.1 Adult hypertrophic pyloric stenosis 2016 2017 2018 2019 Billable/Specific Code Adult Dx (15-124 years) Applicable To Pyloric stenosis NOS Type 1 Excludes congenital or infantile pyloric stenosis ( Q40.0 [icd10data.com]

    Q40 Other congenital malformations of upper alimentary tract Q40.0 Congenital hypertrophic pyloric stenosis Inclusion term(s): Congenital or infantile constriction Congenital or infantile hypertrophy Congenital or infantile spasm Congenital or infantile [icd10coded.com]

    Neonatal pre-pyloric membrane. S Afr Med J. 1967;41:1076-9. Joseph TP, Nair RR. Congenital hypertrophic pyloric stenosis. Indian J Surg. 1974;36:221. Dye TE, Vidals VG, Lockhart CE, Snider WR: Adult hypertrophic pyloric stenosis. [ijpediatrics.com]

  • Nausea

    In addition the patient also complains of frequent pain in the upper part of the abdomen, early satiety, nausea, loss of appetite and weight loss. At times, non-projectile vomiting and jaundice may occur. [medindia.net]

Skin

  • Ulcer

    381 - Complicated Peptic Ulcer W Cc 382 - Complicated Peptic Ulcer W/o Cc/mcc 383 - Uncomplicated Peptic Ulcer W Mcc 384 - Uncomplicated Peptic Ulcer W/o Mcc Chapter Diseases of the digestive system (K00-K95) Block Diseases of esophagus, stomach and [emedcodes.com]

    DRG Group #380-384 - Complicated peptic ulcer without CC or MCC. DRG Group #380-384 - Uncomplicated peptic ulcer with MCC. DRG Group #380-384 - Uncomplicated peptic ulcer without MCC. [icd.codes]

    ICD-10-CM K31.1 is grouped within Diagnostic Related Group(s) (MS-DRG v 36.0): 380 Complicated peptic ulcer with mcc 381 Complicated peptic ulcer with cc 382 Complicated peptic ulcer without cc/mcc 383 Uncomplicated peptic ulcer with mcc 384 Uncomplicated [icd10data.com]

    W MCC 381 -- COMPLICATED PEPTIC ULCER W CC 382 -- COMPLICATED PEPTIC ULCER W/O CC/MCC 383 -- UNCOMPLICATED PEPTIC ULCER W MCC 384 -- UNCOMPLICATED PEPTIC ULCER W/O MCC Clinical Classifications Software CCS CCS Category Number : 141 Description : Other [medicbind.com]

    In peptic ulcer diseases, GOO is usually caused by a combination of edema, spasm, fibrotic stenosis and gastric atony.[ 12 ] Chan et al. reported their experience with 32 children with duodenal ulcers.[ 13 ] GOO caused by peptic ulcer diseases can be [casesjournal.biomedcentral.com]

Psychiatrical

  • Suggestibility

    Zhu J, Zhu T, Lin Z, Qu Y, Mu D Excessive Bright Echoes Sign for Hypertrophic Pyloric Stenosis Suggest the Diagnosis: Gastric Pneumatosis and Portal Venous Gas in Infants Suggest HPS. [medicbind.com]

    It presents with vomiting starting after the second week of birth, suggests it has acquired. Adults Pyloric Stenosis - Pyloric stenosis is more commonly diagnosing among infants; however, it is also developing among adults. [gastrodigestivesystem.com]

    Suggestive clinical presentation combined with lab evaluation should lead to imaging and correction of electrolyte abnormalities. Heller RM, Hernanz-Schulman M. Application of new imaging modalities to the evaluation of common pediatric conditions. [5minuteconsult.com]

    SUGGESTED READING Rose BD. Clinical Physiology of Acid-Base and Electrolyte Disorders. 4th ed. 1994 New York, NY.: McGraw-Hill, Inc Finberg L, Kravath RE, Hellerstein S. [pedsinreview.aappublications.org]

    Markowitz et al[ 10 ] suggested a pyloric channel ulcer as a cause of development of pyloric stenosis. [wjgnet.com]

Neurologic

  • Irritability

    All index IHPS case-patients began having symptoms of either vomiting or excessive irritability while taking erythromycin. [cdc.gov]

    […] respiratory monitoring should be performed for 24 hours because of the risk of apnoea feeding can be restarted within 6 hours of surgery (at surgeon's direction) modest regurgitation is common after pyloromyotomy due to pyloric and antral spasm, and gastric irritation [rch.org.au]

Workup

Other features include a Chief Complaints section addressing the workup and treatment of 50 signs and symptoms, plus a medication index, syndromes glossary, surgical glossary, laboratory values, and tables all for quick reference saving you time and helping [books.google.de]

[…] antrum After upper GI barium study, irrigating and removing any residual barium from the stomach is advisable to avoid aspiration Endoscopy Reserved for patients with atypical clinical signs when ultrasonography and UGI studies are nondiagnostic See Workup [emedicine.medscape.com]

Microbiology

  • Helicobacter Pylori

    Search for Helicobacter pylori was negative in all cases. Failure of specific medical treatment and endoscopic dilatations led to pyloric resection in 3 cases and pyloroplasty in 3 cases. [wwww.unboundmedicine.com]

    This acquired origin of HPS had been identified and discussed since 2000 by Paulozzi (Paulozzi 2000) who argued that HPS result from a Helicobacter pylori infection. [ncbi.nlm.nih.gov]

    Is Helicobacter pylori a cause of infantile hypertrophic Gastroenteritis mimicking idiopathic hypertrophic pyloric stenosis. Is a predominantly infantile disease. Idiopathic hypertrophic pyloric stenosis. [age-reaction.ml]

    The pathologic report showed 1-2 eosinophils per high power field and no evidence of Helicobacter pylori, lymphoid follicles in the gastric mucosa, or granulomatous formation. [wjgnet.com]

    View Article PubMed Google Scholar Lam YH, Lau JY, Fung TM, Ng EK, Wong SK, Sung JJ, Chung SS: Endoscopic balloon dilatation for benign gastric outlet obstruction with or without Helicobacter pylori infection. [casesjournal.biomedcentral.com]

Treatment

When the medical treatment fails, a pyloroplasty is usually curative. [wwww.unboundmedicine.com]

Review the latest developments in the field and get up-to-date clinical information on hot topics like polyps, capsule endoscopy, and pancreatic treatments. [books.google.de]

Treatment : pyloroplasty or pyloromyotomy. Prognosis : good. Pathogenesis Etiology Congenital form: ?Excessive gastrin levels causing hypertrophy of circular muscle fibers. ? Neuromuscular dysfunction. [vetstream.com]

Learn more from WebMD about hypertrophic cardiomyopathy, thickening of the heart muscle, including symptoms, diagnosis, and treatment. Compared with adults. Learn about Antibiotics in Neonates from the Professional. [age-reaction.ml]

Prognosis

Prognosis : good. Pathogenesis Etiology Congenital form: ?Excessive gastrin levels causing hypertrophy of circular muscle fibers. ? Neuromuscular dysfunction. [vetstream.com]

[…] gastric emptying of fluid into duodenum Complications Hypochloremic metabolic alkalosis DDx Infantile pylorospasm Muscle thickness between 1.5 and 3 mm Variable caliber of antral narrowing Antral peristalsis Delayed gastric emptying Elongation of pylorus Prognosis [learningradiology.com]

This condition is known to be rare in Africa, and the cases of late discovery are even rarer in this context because of the early involvement of life prognosis, in the absence of resuscitation. [ncbi.nlm.nih.gov]

Prognosis Surgery is often a complete cure. Most infants do not experience complications or long-term effects. Prevention It is not known how to prevent pyloric stenosis. Resources Books Behrman, Richard E., et al., Nelson Textbook of Pediatrics. [medical-dictionary.thefreedictionary.com]

Etiology

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Its etiology is probably multifactorial as the pylorus seems sensitive to attack at certain times and in certain subjects. Footnotes Competing interests The authors declare that they have no competing interests. [ncbi.nlm.nih.gov]

Clinical entity of unknown etiology. 29 Hypertrophic Pyloric Stenosis In Adults HYPERTROPHIC. Cases have been reported. Is a misleading anatomic and radio. 24 Idiopathic Hypertrophic Pyloric Stenosis In. [age-reaction.ml]

Nine children (age 3 mo to 17 years) presented with a history of late-onset primary GOO of unknown etiology[ 9 ]. [wjgnet.com]

Epidemiology

The epidemiology of infantile hypertrophic pyloric stenosis in a Danish population, 1950-84. Int J Epidemiol 1989;18:413-7. Schechter R, Torfs CP, Bateson TF. The epidemiology of infantile hypertrophic pyloric stenosis. [cdc.gov]

Schechter R, Torfs CP, Bateson TF (1997) The epidemiology of infantile hypertrophic pyloric stenosis. Paediatr Perinat Epidemiol 11: 407–427. View Article Google Scholar 8. [journals.plos.org]

American Journal of Epidemiology. 176 (1): 24–31. doi : 10.1093/aje/kwr493. ISSN 0002-9262. ^ Webb, A. R.; Lari, J.; Dodge, J. (1983). "Infantile hypertrophic pyloric stenosis in South Glamorgan 1970-79". Arch. Dis. [en.wikipedia.org]

Epidemiology. 2006;17(2):195-201. 4. Finkelstein MS, Mandell GA, Tarbell KV. Hypertrophic pyloric stenosis: volumetric measurement of nasogastric aspirate to determine the imaging modality. Radiology. 1990;177(3):759-61. 5. Oakley EA, Barnett PL. [rch.org.au]

Pathophysiology

Water and Electrolytes in Pediatrics: Physiology, Pathophysiology and Treatment. 2nd ed. 1993 Philadelphia, Pa.: WB Saunders Evolution in the Recognition of Infantile Hypertrophic Pyloric Stenosis. Hulka F, Campbell T, Campbell R, Harrison W. [pedsinreview.aappublications.org]

Pathophysiology Failure of pyloric ring to relax → vomiting of stomach contents. [vetstream.com]

What is the pathophysiology of hypertrophic pyloric stenosis. Start studying Pediatric Gastrointestinal Conditions. Primary hypertrophic pyloric stenosis in adults. Posted in IBD Reporter Newsfeed. IDC idiopathic dilated. Pyloric stenosis in adults. [age-reaction.ml]

Pathophysiology Frequent vomiting results in loss of H +, Cl -, Na + and K + (electrolyte concentrations in gastric fluid are 130-150 mmol/L for Cl -, 60-100 mmol/L for Na +, and 10-15 mmol/L for K + ). [rch.org.au]

Pathophysiology [ edit ] The gastric outlet obstruction due to the hypertrophic pylorus impairs emptying of gastric contents into the duodenum. [en.wikipedia.org]

Prevention

/Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis of Alcohol 0% Unclassified 0% Also called [medicbind.com]

Last updated May 6, 2018 BruceBlaus Pyloric Stenosis is the thickening of the muscle layer of the pyloric region resulting in the narrowing of the pyloric sphincter, which prevents the food from leaving the stomach. [dovemed.com]

Prevention It is not known how to prevent pyloric stenosis. Resources Books Behrman, Richard E., et al., Nelson Textbook of Pediatrics. Philadelphia: WB Saunders, 2000. Periodicals Yoshizawa J, et al. [medical-dictionary.thefreedictionary.com]

The prevention of pertussis in infants is important; most hospitalizations for and deaths from pertussis occur in children aged less than 1 year (9). [cdc.gov]

The vomited material does not contain bile because the pyloric obstruction prevents entry of duodenal contents (containing bile) into the stomach. [en.wikipedia.org]

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2.1
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