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[Acquired non hypertrophic pyloric stenosis in children].
Arch Pediatr. 2007 Apr; 14(4):330-3.AP

Abstract

Pediatric non hypertrophic pyloric stenosis (NHPS) are uncommon. Their causes and treatments are debated.

MATERIAL AND METHOD

Retrospective review of all cases of NHPS from 3 pediatric surgery services during the period 1984-2002.

RESULTS

Six children, aged 17 months to 15 years, underwent surgery for NHPS. 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. 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. Post operative course was uneventful with normal oral feeding and normalisation of weight status. Histologic data were aspecific. No recurrence was observed.

DISCUSSION

We discuss the origin of the pyloric stenosis, regarding clinical, operative and pathological data: were the stenosis the cause or consequence of peptic ulcer? Peptic disease is always advocated, but difficult to prove and may be excessively incriminated. Late symptomatic congenital and acquired idiopathic pyloric stenosis should be recalled. 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.

CONCLUSION

The diagnosis of NHPS should be suspected in a child with food vomiting and loss of weight if his age is not concordant with hypertrophic pyloric stenosis. Upper gastro-intestinal series and endoscopy are diagnostic. The precise cause of the stenosis is more difficult to asses. When the medical treatment fails, a pyloroplasty is usually curative.

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Authors+Show Affiliations

Hameury F
Département médicochirurgical de pédiatrie, hôpital J.-Bernard, CHU de Poitiers, 2 rue de la Milétrie, BP 577, 86021 Poitiers cedex, France.
Mcheik J
No affiliation info available
Lardy H
No affiliation info available
Gaudin J
No affiliation info available
Petit T
No affiliation info available
Ravasse P
No affiliation info available
Robert M
No affiliation info available
Maurage C
No affiliation info available
Levard G
No affiliation info available

MeSH

AdolescentChildChild, PreschoolCombined Modality TherapyDiagnosis, DifferentialDilatationFemaleFollow-Up StudiesGastroscopyHumansInfantMalePeptic Ulcer HemorrhagePyloric StenosisRetreatmentRetrospective StudiesVomiting

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

fre

PubMed ID

17187970

Citation

Hameury, F, et al. "[Acquired Non Hypertrophic Pyloric Stenosis in Children]." Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, vol. 14, no. 4, 2007, pp. 330-3.
Hameury F, Mcheik J, Lardy H, et al. [Acquired non hypertrophic pyloric stenosis in children]. Arch Pediatr. 2007;14(4):330-3.
Hameury, F., Mcheik, J., Lardy, H., Gaudin, J., Petit, T., Ravasse, P., Robert, M., Maurage, C., & Levard, G. (2007). [Acquired non hypertrophic pyloric stenosis in children]. Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, 14(4), 330-3.
Hameury F, et al. [Acquired Non Hypertrophic Pyloric Stenosis in Children]. Arch Pediatr. 2007;14(4):330-3. PubMed PMID: 17187970.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Acquired non hypertrophic pyloric stenosis in children]. AU - Hameury,F, AU - Mcheik,J, AU - Lardy,H, AU - Gaudin,J, AU - Petit,T, AU - Ravasse,P, AU - Robert,M, AU - Maurage,C, AU - Levard,G, Y1 - 2006/12/21/ PY - 2006/06/29/received PY - 2006/11/13/accepted PY - 2006/12/26/pubmed PY - 2007/7/17/medline PY - 2006/12/26/entrez SP - 330 EP - 3 JF - Archives de pediatrie : organe officiel de la Societe francaise de pediatrie JO - Arch Pediatr VL - 14 IS - 4 N2 - UNLABELLED: Pediatric non hypertrophic pyloric stenosis (NHPS) are uncommon. Their causes and treatments are debated. MATERIAL AND METHOD: Retrospective review of all cases of NHPS from 3 pediatric surgery services during the period 1984-2002. RESULTS: Six children, aged 17 months to 15 years, underwent surgery for NHPS. 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. 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. Post operative course was uneventful with normal oral feeding and normalisation of weight status. Histologic data were aspecific. No recurrence was observed. DISCUSSION: We discuss the origin of the pyloric stenosis, regarding clinical, operative and pathological data: were the stenosis the cause or consequence of peptic ulcer? Peptic disease is always advocated, but difficult to prove and may be excessively incriminated. Late symptomatic congenital and acquired idiopathic pyloric stenosis should be recalled. 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. CONCLUSION: The diagnosis of NHPS should be suspected in a child with food vomiting and loss of weight if his age is not concordant with hypertrophic pyloric stenosis. Upper gastro-intestinal series and endoscopy are diagnostic. The precise cause of the stenosis is more difficult to asses. When the medical treatment fails, a pyloroplasty is usually curative. SN - 0929-693X UR - https://wwww.unboundmedicine.com/medline/citation/17187970/[Acquired_non_hypertrophic_pyloric_stenosis_in_children]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0929-693X(06)00590-2 DB - PRIME DP - Unbound Medicine ER -