Abstract
21.1
General considerations
■ Hypertrophy of the pyloric muscle causes gastric outlet obstruction
■ Incidence 1:250 live births, most common in Caucasian populations
■ 4:1 male-to-female ratio
■ Family history often positive, particularly sons born to affected mothers, indicating a polygenic pattern of inheritance
■ Etiology largely unknown
21.2
Hypertrophy of the pyloric muscle causing gastric outlet obstruction is a common condition of unknown etiology. The prognosis is excellent, with definitive surgery following adequate resuscitation.
21.3
General considerations
■ Incidence about 1:10,000 births
■ Approximately 70% of congenital intestinal stenoses and 45% of atresias are found in the duodenal region
■ 30% have trisomy 21 (Down’s syndrome)
■ Diagnosis is possible antenatally
• 17%–57% have associated polyhydramnios
• Antenatal ultrasonography may identify a dilated stomach and proximal duodenum (double-bubble)
• Antenatal diagnosis should prompt a detailed search for associated anomalies and amniocentesis
■ The majority of cases are diagnosed in the early newborn period
■ Other associated anomalies include:
• Congenital heart disease (~20%)
• Malrotation (~20%)
• Esophageal atresia and tracheo-esophageal fistula (~20%)
• Genito-urinary anomalies (~9%)
• Anorectal anomalies (~3%)
• VACTERL association (vertebral abnormalities, anal atresia, cardiac abnormalities, tracheoesophageal fistula and/or esophageal atresia, renal agenesis and dysplasia and limb defects)
Keywords
- Congenital Heart Disease
- Percutaneous Endoscopic Gastrostomy
- Esophageal Atresia
- Gastric Outlet Obstruction
- Renal Agenesis
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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© 2009 Springer-Verlag Berlin Heidelberg
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Losty, P., Almond, S., Smith, N., Zachariou, Z. (2009). Stomach and Duodenum. In: Zachariou, Z. (eds) Pediatric Surgery Digest. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-34033-1_21
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DOI: https://doi.org/10.1007/978-3-540-34033-1_21
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-34032-4
Online ISBN: 978-3-540-34033-1
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