Endoscopic evaluation of the hypertrophic pyloric stenosis in the adult was discussed on 10 of 19 cases in Japan including our 4 cases. Nine diffuse forms (by Skoryna) showed "protruded lesion, deformity, irregularity and stenosis of the pyloric ring, pyloric narrowing unaffected by anticholinergic agents, and irregular mucosal folds adjacent to the pylorus". One focal form showed only a tumor like lesion on the lesser curvature of the pylorus. Associated gastric ulcers should be carefully observed. Frontal view type upper GI endoscope should be used for the diagnosis of the hypertrophic pyloric stenosis in the adult.
Large and middle sized type (8 cases) : Usually, in addition to distinct localization,-feeding arteries and draining veins of the malformations, main cerebral vessels were clearly demonstrated. They have tendency to develop not so severe subarachnoid hemorrhage. Total extirpation would be a treatment of choice. 3) Small arteriovenous malformations (8 cases) : They tended to cause intracerebral hematomas, evacuation of which usually gave excellent results. We have another subgroup (3 cases) in which angiograms revealed abnormal veins alone, though the size of the malformations corresponded to this group. Among the above-mentioned material there were two cases which showed aneurysmal sac formation in the arteriovenous malformations.
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