Presents more than 1,200 optimally sized multi-modality clinical images to help you recognize the characteristic appearance of both common and uncommon GI disorders. [books.google.com]

In severe cases, a scaphoid abdomen and protruding ribcage may be present. 1,2 Atypical Presentations Premature infants with IHPS and those with certain medical or surgical conditions may present atypically. [mdedge.com]

• Surgical Procedure

  Intravenous fluids Surgical procedure Doctors give infants fluids by vein (intravenously) to treat the dehydration and correct any electrolyte imbalance. [msdmanuals.com]

  The most common surgical procedures performed for GOO related to PUD are vagotomy and antrectomy, vagotomy and pyloroplasty, truncal vagotomy and gastrojejunostomy, pyloroplasty, and laparoscopic variants [7] of the aforementioned procedures. [emedicine.medscape.com]

  If medical therapy conducted for a reasonable period fails to alleviate the obstruction, then surgical intervention becomes appropriate. The choice of surgical procedure depends upon the patient’s particular circumstances. [laparoscopyhospital.com]

  A surgical procedure called pyloromyotomy, which involves cutting through the thickened muscles of the pylorus, will relieve the blockage. [kidshealth.org]

  This is a procedure in which there is a surgical creation of a connection between the stomach and jejunum bypassing the obstruction. [rarediseases.org]

• Anemia

  Routine investigations were normal except mild anemia. [jdeonline.in]

  Alper et al. [ 6 ] showed that a large pedunculated antral hyperplastic polyp may cause gastric outlet obstruction and iron deficiency anemia by prolapsing into the duodenum through the pyloric channel. [bmcgastroenterol.biomedcentral.com]

  Depending on the location and size, clinical manifestations of gastrointestinal bezoars can vary, such as abdominal pain, bloody or tarry stool, abdominal fullness, anemia—or even upper GI bleeding—or signs of intestinal obstruction due to large intestinal [academic.oup.com]

  In older persons, 20 percent of bleeding episodes result from asymptomatic ulcers. 17 Patients may present with hematemesis (bright red or “coffee ground”), melena, fatigue caused by anemia, orthostasis, or syncope. [aafp.org]

  On admission his laboratory analyses showed mild hypochloremic metabolic alkalosis and moderate iron deficiency anemia without eosinophilia. Stool occult blood had been negative on several occasions. [wjgnet.com]

• Swelling

  Pyloric stenosis is a thickening or swelling of the pylorus — the muscle between the stomach and the intestines — that causes severe and forceful vomiting in the first few months of life. It is also called infantile hypertrophic pyloric stenosis. [chop.edu]

  […] especially first-born boys) Parents or siblings who had pyloric stenosis Use of certain antibiotics (for example, erythromycin ) during the first few weeks of life Smoking during pregnancy Rarely, some older children have pyloric obstruction caused by swelling [msdmanuals.com]

  This will help ease swelling of the area and allow it to heal in the case of peptic ulcer disease. Supportive treatment is crucial in severe cases. [healthhype.com]

  Because of swelling at the surgery site, a baby may still vomit small amounts for a day or so. [kidshealth.org]

  Symptoms of a complete blockage of the duodenum may include bilious vomiting (a yellow-green secretion arising from the liver or in some cases a clear or light brown granular matter) typically beginning a few hours after birth, distention or swelling [rarediseases.org]

• Weight Gain

  I felt this was the safest option for this malnourished patient who is 74 years old, and although it is possible that weight gain may be an issue, she could have revision bariatric surgery in the future at some point should she so desire; however, at [aapc.com]

  Some infants experience poor feeding and weight loss, but others demonstrate normal weight gain. Constant hunger, belching, and colic are other possible signs of pyloric stenosis because your baby is not able to eat properly. [chop.edu]

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

  She showed significant clinical improvement with resolution of vomiting and weight gain. [jdeonline.in]

• Asymptomatic

  The same strategy can be used for asymptomatic polyps, where biopsy samples may yield inconclusive results by sampling error. [bmcgastroenterol.biomedcentral.com]

  In older persons, 20 percent of bleeding episodes result from asymptomatic ulcers. 17 Patients may present with hematemesis (bright red or “coffee ground”), melena, fatigue caused by anemia, orthostasis, or syncope. [aafp.org]

  "Pyloric muscle in asymptomatic infants: sonographic evaluation and discrimination from idiopathic hypertrophic pyloric stenosis". Pediatric Radiology. 28 (6): 429–34. doi:10.1007/s002470050377. PMID 9634457. ^ Askew, Nathan (October 2010). [en.wikipedia.org]

  Rohrschneider WK, Mittnacht H, Darge K, Tröger J (1998) Pyloric muscle in asymptomatic infants: sonographic evaluation and discrimination from idiopathic hypertrophic pyloric stenosis. Pediatr Radiol 28: 429–434. View Article Google Scholar 20. [journals.plos.org]

• Cough

  Babies given certain antibiotics in the first weeks of life — erythromycin to treat whooping cough, for example — have an increased risk of pyloric stenosis. [mayoclinic.org]

  형태(Psychogenic forms of Da Costa's syndrome) 위장성 신경증의 심인성 형태(Psychogenic forms of Gastric neurosis) 신경순환성 무력증의 심인성 형태(Psychogenic forms of Neurocirculatory asthenia) 공기연하증(空氣嚥下症)의 심인성 형태(Psychogenic forms of aerophagy) 해소의 심인성 형태(Psychogenic forms of cough [dic.impact.pe.kr]

• Vomiting

  They include: Vomiting. The first symptom is usually vomiting. [kidshealth.org]

  Being sick (vomiting) after a feed is the main symptom. The vomiting often starts like a 'normal' vomit and milk just dribbles down the front of the baby. Sometimes the vomiting is forceful and milk may be vomited quite a distance like a fountain. [patient.info]

  Some vomiting may be expected during the first days after surgery as the gastrointestinal tract settles. If vomiting continues we may prescribe an antacid. The stomach lining can become inflamed with the persistent vomiting. [chop.edu]

  Signs include: Vomiting after feeding. The baby may vomit forcefully, ejecting breast milk or formula up to several feet away (projectile vomiting). Vomiting might be mild at first and gradually become more severe as the pylorus opening narrows. [mayoclinic.org]

  A 7-week-old white boy presented to the emergency department (ED) with vomiting and weight loss. His parents brought him to the ED 3 weeks earlier after he had vomited for several days. [consultant360.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]

  Symptoms of small bowel obstruction may include the following: Abdominal (stomach) cramps and pain Bloating Vomiting Nausea Dehydration Malaise (an overall feeling of illness) Lack of appetite Severe constipation. [my.clevelandclinic.org]

  Typical symptoms and signs are abdominal distention, pain, constipation, nausea, and vomiting, with partial obstructions leading to less severe symptoms. Severe cases are often accompanied by dehydration and electrolyte abnormalities. [amboss.com]

  Background Gastric outlet obstruction (GOO) presents with nausea and vomiting and usually develops over weeks to months [ 1 ]. It may be complete or incomplete with intermittent symptoms. [bmcgastroenterol.biomedcentral.com]

  It may be preceded by indigestion and nausea as the stomach attempts to squeeze its contents through an ever narrowing outlet. Hypertrophic pyloric stenosis appears soon after birth. [medical-dictionary.thefreedictionary.com]

• Projectile Vomiting

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

  But these babies don't have projectile vomiting. gastroenteritis (inflammation in the digestive tract that can be caused by viral or bacterial infection) also can cause vomiting and dehydration. [kidshealth.org]

  Infants with pyloric stenosis are hungry and feed well but vomit forcefully (projectile vomiting) shortly after eating. Some infants vomit so much that they become dehydrated and undernourished. [msdmanuals.com]

  Signs include: Vomiting after feeding. The baby may vomit forcefully, ejecting breast milk or formula up to several feet away (projectile vomiting). Vomiting might be mild at first and gradually become more severe as the pylorus opening narrows. [mayoclinic.org]

  </li> <li>Symptoms include persistent projectile vomiting (not simply 'spitting up') and hunger after vomiting.</li> <li>Seek medical assistance right away if you think your baby is dehydrated or has pyloric stenosis. [aboutkidshealth.ca]

• Delayed Gastric Emptying

  […] and slow recovery of gastric emptying. [emedicine.medscape.com]

  The phytobezoars form as a complication of delayed gastric emptying. [academic.oup.com]

  An anatomically patent gastrojejunostomy may fail to empty for days. This syndrome of delayed gastric emptying is a well-known entity and requires surgical patience. [laparoscopyhospital.com]

  A degree of pylorospasm is common in infancy and is responsible for some delay in gastric emptying. The pylorus, however, appears sonographically normal. [radiopaedia.org]

  This syndrome of delayed gastric emptying is a well-known entity and requires surgical patience. [slideshare.net]

• Abdominal Pain

  The most frequent symptoms of phytobezoars in the stomach are dyspepsia, abdominal pain and vomiting or nausea. [academic.oup.com]

  Case presentation A 73-year-old male presents with a 5-week history of nausea, vomiting, and abdominal pain. [ncbi.nlm.nih.gov]

  This patient presented with late postpandrial vomiting and diffuse abdominal pain after ingesting solid food. After one month of these symptoms, vomiting was even caused by the intake of liquids, accompanied by asthenia, anorexia and weight loss. [pesquisa.bvsalud.org]

  pain, swollen abdomen, abdominal distension, vomiting, fecal vomiting and constipation. [en.wikipedia.org]

  Absence of abdominal pain in older persons with endoscopic ulcers: a prospective study. Am J Gastroenterol. 2001;96:380–4. 17. Martinez JP, Mattu A. Abdominal pain in the elderly. Emerg Med Clin North Am. 2006;24:371–88. 18. Hassall E. [aafp.org]

• Fussiness

  Many children are fussy in this pre-surgery time because they cannot eat, but it is extremely important to minimize the chances that they vomit. [chop.edu]

  A baby with pyloric stenosis may want to constantly feed or be fussy because of hunger. Constipation. Without adequate food and liquid reaching the intestines, the condition can cause constipation. Stomach cramps. [healthline.com]

• Withdrawn

  B: The superficial incision is made using the sheathed arthroscopy knife with the sheath withdrawn. C: The myotomy is created by pulling with the arthroscopy knife blade sheathed. [basicmedicalkey.com]

  The tube was withdrawn and oral feedings were begun 16 days later. Patient 2 The second index patient was a full-term baby girl born after a normal pregnancy and delivery (weight, 3 kg) who was noted to have cyanotic spells at 18 hours of age. [nejm.org]

• Lethargy

  Vomiting may be less forceful, and the classic finding of visible gastric peristalsis may or may not be present. 9 Researchers have documented cases in which hospitalized premature infants had nonprojectile vomiting, weight loss, and lethargy that were [mdedge.com]

  […] uterine contraction during labor. 9 10 11 Infusions of prostaglandin E 1 cause respiratory depression in about 10 percent of neonates, cardiovascular effects in 20 percent, generalized flushing in 10 percent, and central nervous system effects (fever, lethargy [nejm.org]

  Neuroleptic Malignant Syndrome Creutzfeldt- Jacob Disease Malignant Hyperthermia Baclofen Toxicity Clinical Features Confusion* Confusion* Confusion Confusion* Confusion* Apathy Apathy* Drowsiness Agitation Agitation* Agitation/ lability Agitation/lability* Lethargy [liveto.com]

• Agitation

  Agitation* Agitation/ lability Agitation/lability* Lethargy Hallucination Hallucination Rigidity Spasticity/rigidity* Rigidity/akinesia* Rigidity* Rigidity* Myoclonias* Myoclonias* Myoclonias* Myoclonias* Tremor Tremor* Tremor Tremor* Intention tremor [liveto.com]

• Apathy

  Apathy* Drowsiness Agitation Agitation* Agitation/ lability Agitation/lability* Lethargy Hallucination Hallucination Rigidity Spasticity/rigidity* Rigidity/akinesia* Rigidity* Rigidity* Myoclonias* Myoclonias* Myoclonias* Myoclonias* Tremor Tremor* Tremor [liveto.com]

Each chapter includes suggested radiologic workups and key points summaries. [books.google.com]

Surgical Bowel obstruction requires a swift workup to establish whether emergent surgery is necessary! References: [1] [amboss.com]

As part of the initial workup, exclude the possibility of functional nonmechanical causes of obstruction, such as diabetic gastroparesis. [emedicine.medscape.com]

WORKUP Laboratory Studies • Obtain a CBC. Check the hemoglobin and hematocrit to. rule out the possibility of anemia. • Obtain an electrolyte panel. [slideshare.net]

• Prolonged PR Interval

  الصفحة 286 - Clinical findings Arthralgia Fever Laboratory findings Elevated acute phase reactants Erythrocyte sedimentation rate C-reactive protein Prolonged PR interval Supporting Evidence of Antecedent Group A Streptococcal Infection Positive throat [books.google.com]

Significant updates on bariatric surgery, Barrett's esophagus, endoscopic ultrasound, endosonography, treatment of liver disease, and much more keep you current on the latest advances. [books.google.com]

[citation needed] Treatment[edit] Treatment of gastric outlet obstruction depends on the cause, but is usually either surgical or medical. [en.wikipedia.org]

Learn more about treatment for gastric cancer at Johns Hopkins. [hopkinsmedicine.org]

Treatment of Peptic Ulcer Disease Figure 1. Algorithm for the treatment of peptic ulcer disease. [aafp.org]

Two aspects need to be addressed in treatment: Anti-tubercular medications Relief from obstruction. Anti-tuberculous treatment should be given according to standard WHO guideline. There is no specific guideline for prolonging ATT beyond 6 months. [jdeonline.in]

Prognosis[edit] The prognosis for non-ischemic cases of SBO is good with mortality rates of 3–5%, while prognosis for SBO with ischemia is fair with mortality rates as high as 30%.[25] Cases of SBO related to cancer are more complicated and require additional [en.wikipedia.org]

Described sonographic signs include: antral nipple sign cervix sign target sign Treatment and prognosis Initial medical management is essential with rehydration and correction of electrolyte imbalances. [radiopaedia.org]

Prognosis A functioning and unrestricted intestine is a prerequisite for living independent of the most advanced and continuous medical care available. Achieving this desirable goal is the rule with surgery for duodenal obstructions of all types. [medical-dictionary.thefreedictionary.com]

Prognosis of nonconvulsive status epilepticus Types Prognosis Response to AEDs Recurrence Outcome I. Generalized NCSE Ia. Absence status ⅰ. Typical absence ExceExcellent Excellent Frequent No morbidity or mortality ⅱ. [liveto.com]

• In patients with largely metastatic disease, determine the degree of surgical intervention for palliation in light of the patient's realistic prognosis and personal wishes. 22. [slideshare.net]

► LEARN ABOUT: - Hypertrophic of the Pylorus - Common causes of Hypertrophic Pyloric Stenosis - Etiology and risk factors - Examination: History and Physical - Sunken Fontanelle - Labs and Ultrasound of an lethargic Baby - Initial Management of Hypertrophic [youtube.com]

Pathology Etiology Gastric outlet obstruction can be due to malignant or benign causes. [radiopaedia.org]

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

Typically, treated infants recover quickly and can begin feeding within hours after surgery. 3,8 Although the etiology of IHPS remains unknown, providers can quickly recognize the signs and symptoms of IHPS in order for surgical treatment to be scheduled [mdedge.com]

The incidence of GOO in patients with peripancreatic malignancy, the most common malignant etiology, has been reported between 15- 20%. [tropicalgastro.com]

Structures every chapter consistently to include Findings, Imaging Modalities, Clinical Presentation, Pathology, Incidence/Prevalence and Epidemiology, What the Referring Physician Needs to Know, Suggested Readings, and Selected Images to make reference [books.google.com]

KEY WORDS epidemiology infantile hypertrophic pyloric stenosis SIDS Abbreviations: ICD-10 — International Classification of Diseases, 10th Revision IHPS — infantile hypertrophic pyloric stenosis IQR — interquartile range IRR — incidence relative ratios [pediatrics.aappublications.org]

"Infantile hypertrophic pyloric stenosis: epidemiology, genetics, and clinical update". Advances in Pediatrics. 58 (1): 195–206. doi:10.1016/j.yapd.2011.03.005. PMID 21736982. ^ a b c Georgoula, C; Gardiner, M (August 2012). [en.wikipedia.org]

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]

Epidemiology. 2006 Mar;17(2):195-201. PMID: 16477261. RCH Melbourne CPG. Pyloric stenosis. Sola JE, Neville HL. Laparoscopic vs open pyloromyotomy: a systematic review and meta-analysis. J Pediatr Surg. 2009 Aug;44(8):1631-7. [lifeinthefastlane.com]

It provides complete, authoritative information on the biology of the newborn and the pathophysiology and management of diseases during the neonatal period. [books.google.com]

Pathophysiology Intrinsic or extrinsic obstruction of the pyloric channel or duodenum is the usual pathophysiology of GOO; the mechanism of obstruction depends upon the underlying etiology. [emedicine.medscape.com]

Malignant Tumours of the stomach, including adenocarcinoma (and its linitis plastica variant), lymphoma, and gastrointestinal stromal tumours Pathophysiology[edit] In a peptic ulcer it is believed to be a result of edema and scarring of the ulcer, followed [en.wikipedia.org]

Pathophysiology Intrinsic or extrinsic obstruction of the pyloric channel or duodenum is the usual pathophysiology of GOO; as previously noted, the mechanism of obstruction depends upon the underlying etiology. [laparoscopyhospital.com]

In order to prevent closure of the gastrostomy, a Foley catheter was immediately put in place. Several hours later the patient presented with vomiting. [revistagastroenterologiamexico.org]

Prevention of bacterial endocarditis. Recommendations by the American Heart Association. ‏ [books.google.com]

Oversew the area with a continuous suture to prevent a postoperative leak. No drainage procedure is required. E. Complications 1. [laparoscopyhospital.com]

Prevention Prompt and effective treatment of peptic ulcers will prevent chronic scarring and narrowing. Drugs developed over the past few decades have all but eliminated the need for ulcer surgery. [medical-dictionary.thefreedictionary.com]

SALINAS, MD, is an assistant professor in the Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center. [aafp.org]