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Hipertrofia del piloro

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16 papers 0 to 25 followers
Aurélien Binet, C Klipfel, P Meignan, F Bastard, A R Cook, K Braïk, A Le Touze, T Villemagne, M Robert, Q Ballouhey, F Lengelle, S Amar, H Lardy
INTRODUCTION: Pyloromyotomy is the standard care for hypertrophic pyloric stenosis. The traditional approach for this procedure is a right upper quadrant transverse incision, although other "open" approaches, such as circumumbilical or periumbilical incision have been described. The more recent approach used is laparoscopic pyloromyotomy (LP), but experience feedback is still debated and its benefits remain unproven. The aim of this study was to make a review of all our LP procedures with an objective evaluation according to the literature...
April 2018: Pediatric Surgery International
Brian G A Dalton, Katherine W Gonzalez, Sushanth R Boda, Priscilla G Thomas, Ashley K Sherman, Shawn D St Peter
BACKGROUND: Hypertrophic pyloric stenosis (HPS) is the most common diagnosis requiring surgery in infants. Electrolytes are used as a marker of resuscitation for these patients prior to general anesthesia induction. Often multiple fluid boluses and electrolyte panels are needed, delaying operative intervention. We have attempted to predict the amount of IV fluid boluses needed for electrolyte correction based on initial values. METHODS: A single center retrospective review of all patients diagnosed with HPS from 2008 through 2014 was performed...
August 2016: Journal of Pediatric Surgery
Shannon N Acker, Allan J Garcia, James T Ross, Stig Somme
AIM: We hypothesized that recent trends towards earlier diagnosis of hypertrophic pyloric stenosis continued throughout the early part of the 21st century. METHODS: We reviewed the medical records of patients with HPS at a single institution during two periods: 1/03-12/05 and 4/09-7/13. RESULTS: A total of 433 patients with hypertrophic pyloric stenosis who underwent pyloromyotomy were included (modern cohort = 259; historic = 174). The two cohorts did not differ in terms of age, weight, or median time from symptom onset to physician (5 vs 6...
April 2015: Pediatric Surgery International
Sigmund H Ein, Peter T Masiakos, Arlene Ein
PURPOSE/BACKGROUND: The aim of the study is to evaluate a large series of infantile hypertrophic pyloric stenosis (IHPS) patients treated by one pediatric surgeon focusing on their diagnostic difficulties and complications. METHODS: From July 1969 to December 2003 (inclusive), the charts of 791 infants with IHPS were retrospectively reviewed. RESULTS: There were 647 (82%) males and 144 (18%) females; mean age was 38 days, median 51 (range 7 days-10 months)...
May 2014: Pediatric Surgery International
Samir Pandya, Kurt Heiss
Pyloric stenosis is a common pediatric surgical problem that requires a combination of both medical and surgical attention. This article reviews the classical elements necessary to care for the patient in a safe and effective manner. A well-tested management approach that can be applied to the general surgical environment is described. Perioperative management of the patient is discussed and the currently used techniques are reviewed. Current recommendations include the routine use of ultrasonography for diagnosis, attention to the preoperative correction of electrolytes, and the use of minimally invasive techniques for treatment...
June 2012: Surgical Clinics of North America
Y El-Gohary, B H Yeap, G Hempel, J Gillick
INTRODUCTION: Pyloric stenosis is a common cause of vomiting in infancy and is usually treated with a Ramstedt's pyloromyotomy. In this study we retrospectively reviewed our experience with the circumumbilical incision for the treatment of pyloric stenosis with a particular emphasis on the relation between postoperative emesis and postoperative time to feeds. MATERIAL AND METHOD: The medical records of all patients undergoing pyloromyotomy for IHPS from January 2000 to December 2008 were reviewed retrospectively...
November 2010: European Journal of Pediatric Surgery
Lena Perger, Julie R Fuchs, Luka Komidar, David P Mooney
PURPOSE: The aim of this study is to compare the outcome of 3 different approaches to pyloromyotomy in a large single institution series. METHODS: Records of consecutive patients undergoing pyloromyotomy for an 8-year period were reviewed. Patients' age, sex, weight, operating time, length of stay, number of emeses, and complications were recorded. Variables were compared between right upper quadrant (RUQ), umbilical (UMB), and laparoscopic (LAP) approaches. RESULTS: Six hundred twenty-two patients were included in the study...
November 2009: Journal of Pediatric Surgery
Gudrun Aspelund, Jacob C Langer
Hypertrophic pyloric stenosis (HPS) is a common condition affecting infants that presents with progressive projectile nonbilious vomiting. The pyloric portion of the stomach becomes abnormally thickened and manifests as gastric outlet obstruction. The cause is unknown. Pyloromyotomy remains the standard of treatment and outcome is excellent. This article reviews the diagnostic work up and imaging, preoperative resuscitation, the various surgical approaches used, and the effect of subspecialty training on outcomes after pyloromyotomy...
February 2007: Seminars in Pediatric Surgery
Liu Hua, Dongping Shi, Phyllis R Bishop, John Gosche, Warren L May, Michael J Nowicki
Hypertrophic pyloric stenosis (HPS) may be accompanied by jaundice, a condition referred to as the icteropyloric syndrome (IPS). It has long been suspected that the etiology of IPS is an early manifestation of Gilbert's syndrome (GS). Clinical features common to both GS and IPS include jaundice precipitated by fasting and improved with feeding. Prevalence of jaundice in HPS is similar to that of clinically apparent GS in the general population. Discovery of a mutation in the promoter region of the bilirubin uridine diphosphate glucuronosyl transferase gene (UGT1A1*28) as the most common cause of GS has provided a tool to determine the role of GS in IPS...
November 2005: Pediatric Research
Jacob C Langer, Teresa To
OBJECTIVE: Ramstedt pyloromyotomy is a common operation in infants and is often done by general surgeons. We wished to determine whether there are any differences in outcome when this procedure is done by subspecialist pediatric general surgeons as compared with general surgeons. METHODS: All Ramstedt pyloromyotomies in the province of Ontario between 1993 and 2000 were reviewed. Children with complex medical conditions or prematurity were excluded. Cases done by general surgeons were compared with those done by pediatric surgeons, specifically examining hospital stay and complications...
May 2004: Pediatrics
D Alberti, M Cheli, G Locatelli
BACKGROUND: Since its first publication in 1986, the Tan-Bianchi procedure for treatment of infantile hypertrophic pyloric stenosis has displayed a growing consensus among pediatric surgeons. However, in up to 30% of cases, the supraumbilical skin fold incision does not allow a comfortable access. Delivery through this route, a large pyloric tumor into the wound to perform a pyloromyotomy, can be fairly difficult and time consuming and may damage the gastric or duodenal serosa by tearing...
January 2004: Journal of Pediatric Surgery
R Ordorica-Flores, V León-Villanueva, E Bracho-Blanchet, R Reyes-Retana, R Dávila-Perez, G Varela-Fascinetto, J M Tovilla-Mercado, P Lezama-DelValle, J Nieto-Zermeño
PURPOSE: The aim of this study was to compare the incidence of surgical complications (duodenal perforation, postoperative vomiting, wound infection or dehiscence, incisional hernia) between 2 different surgical techniques for the resolution of hypertrophic pyloric stenosis in children. METHODS: A clinically controlled, randomized study with follow-up from 24 to 36 months was conducted. One hundred children between 15 days and 2 months old, who underwent surgical resolution of hypertrophic pyloric stenosis, were put randomly into 2 groups: I, pyloric traumamyoplasty (n = 43); II, Fredet-Ramstedt pyloromyotomy (n = 57)...
July 2001: Journal of Pediatric Surgery
F Hulka, M W Harrison, T J Campbell, J R Campbell
BACKGROUND: Few references exist regarding contemporary complications of pyloromyotomy (PM) for infantile hypertrophic pyloric stenosis (IHPS). Therefore, we reviewed the frequency and outcome of patients with IHPS who developed complications from PM. METHOD: A 25-year retrospective review was performed in two populations. The first group included all infants who had a PM for IHPS at two pediatric surgery centers. The second group included all infants referred from other institutions who developed complications following PM for IHPS...
May 1997: American Journal of Surgery
D W Hight, C D Benson, A I Philippart, J H Hertzler
Mucosal perforation during Fredet-Ramstedt pyloromyotomy is the cause of unnecessary morbidity and death if unrecognized. Previously, a variety of closure have been advocated. In 1,777 cases there has been 42 (2.3%) intraoperative perforations. One unrecognized perforation led to a postoperative death. Closure of a mucosal tear is accomplished safely by a simplified suture technique without prolonged convalescence or death.
July 1981: Surgery
S Ekkelkamp, A Vos
In this series of 114 patients with infantile hypertrofic pyloric stenosis all were treated operatively, in eight cases perforations of the mucosa occurred, seven patients were referred to us after inadequate pyloromyotomy had been performed elsewhere. They did well after an adequate pyloromyotomy at reoperation. The conclusion is that pyloromyotomy is a most rewarding treatment for IHPS, that complications are rare and if occurring, can be dealt with without any lasting harm to the patient.
April 1983: Tijdschrift Voor Kindergeneeskunde
R A Wheeler, A S Najmaldin, N Stoodley, D M Griffiths, D M Burge, J D Atwell
In a prospective randomized study three different feeding regimens after operation were compared in 74 babies with infantile hypertrophic pyloric stenosis: gradual regarding of feeds over 48 h (regimen 1), rapid regarding of feeds over 16 h (regimen 2), and initial starvation followed by full normal feeds at 24 h (regimen 3). No significant difference between the treatment groups was found either in episodes of vomiting after operation (regimen 1, 2.9 episodes in 21 patients; regimen 2, 3.6 episodes in 28 patients; regimen 3, 3...
September 1990: British Journal of Surgery
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