What are the symptoms of pyloric stenosis?

There is currently no specific cause to explain the occurrence of pyloric stenosis, but generally pyloric stenosis is related to the patient's incomplete development of the nerve plexus. Patients with pyloric stenosis generally experience boredom and vomiting, especially infants. Parents must always pay attention to whether their children's behavior is normal. If similar symptoms occur, they should be examined in time.

Cause and Introduction:

There is no satisfactory explanation for the cause of this disease so far. It is currently recognized that it may be related to the incomplete development or absence of the nerve plexus between the pyloric muscles, which causes poor relaxation of the pyloric sphincter and causes compensatory hypertrophy of the pyloric muscles of the stomach. Its pathological characteristics are highly hypertrophic and proliferative pyloric sphincter, which is as hard as cartilage and olive-shaped, and severe stenosis of the pyloric canal, resulting in obvious mechanical obstruction.

General treatment and prevention

If the condition does not improve after taking sedatives, antispasmodics and correcting water and electrolyte imbalances, surgical treatment should be given. A transverse incision is usually made in the right upper abdomen. After laparotomy, the circular muscle of the pylorus is cut longitudinally without cutting the mucosa. The severed muscle ring is then separated and the mucosa is allowed to protrude from the wound edge, thereby expanding the pyloric opening and relieving the obstruction. During the operation, be careful not to let the distal end of the incision on the tumor exceed the duodenum to avoid cutting and causing duodenal fistula.

Symptoms

Symptoms of pyloric obstruction usually appear in the 2nd or 3rd week after birth:

a. Regurgitation and vomiting, which occurs immediately or 10 minutes after eating. The vomiting is projectile and does not contain bile. Early cases present with galactorrhea.

b. Gastric peristaltic waves can be seen moving from under the left rib to the right and disappearing in the right upper abdomen.

c. Pyloric mass: in about 90% of cases, a 2×1cm mass with clear edges, hard as cartilage, spindle shape and smooth surface can be felt in the right upper abdomen (usually between the lower edge of the liver and the outer edge of the rectus abdominis muscle). The examination is best performed when the child is asleep or sucking milk.

d. Barium meal examination: barium is mixed with milk and examined after the meal. It can be seen that the stomach is dilated and the lower end is cone-shaped, with strong and deep peristaltic waves that suddenly disappear at the pyloric part. Very little barium enters the duodenum, and the barium passes through the pyloric cavity in the form of a thin line. Gastric emptying is slow.

eB-type ultrasound detection showed a low-echo mass (substantial dark area), which was located on the inner side of the gallbladder, in front of the right kidney and on the outer side of the pancreatic head during transverse scanning; it was located on the posterior and inferior side of the gallbladder during longitudinal scanning. The mass was about 1 cm in diameter with a round or star-shaped image in the center.