Congenital Double Pylorus

Sufian, Shekeeb; Ominsky, S H; Matsumoto, Teruo

doi:10.1016/s0016-5085(19)32288-7

Cited by 33 publications

(8 citation statements)

References 9 publications

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“…We identified five other patients with congenital double pylorus (Table 1) (3,4,(6)(7)(8). None had evidence of ulcer disease.…”

Section: Discussionmentioning

confidence: 99%

“…Both represent a variation in embryonic development. Diverticula are constant features of embryonic development toward the end of the second month (7,9), and congenital diverticula are considered to persist from embryonic diverticula. Congenital diverticula in the prepyloric area are likely to be associated with aberrant pancreatic tissue (10).…”

Section: Discussionmentioning

confidence: 99%

“…Persistence of embryonic diverticula and persistence of vacuoles within the epithelium of the primitive foregut have also been proposed as etiologies (12). Because the stomach does not go through a period of occlusion and recanalization of its lumen, adhesion of longitudinal folds has been suggested as a possible cause of gastric duplication, but it is not clear whether this can be postulated for the pyloroduodenal region (7).…”

Section: Discussionmentioning

confidence: 99%

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A Gastric Diverticulum Containing Pancreatic Tissue and Presenting as Congenital Double Pylorus: Case Report and Review of the Literature

Wolters

Nikkels²,

Zee³

et al. 2001

Journal of Pediatric Gastroenterology and Nutrition

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Double pylorus is a rare condition consisting of a double communication between the gastric antrum and the duodenal bulb. Double pylorus can occur as a congenital abnormality or as a complication of peptic ulcer disease. Although almost 100 patients with acquired double pylorus have been described (1,2), only a few patients with congenital double pylorus have been described, and, in only one patient, this anomaly was recognized in childhood (3). Herein we describe another child with congenital double pylorus, who presented with gastric outlet obstruction. CASE REPORTThe patient, a 5.5-year-old boy, was referred to us because of poor weight gain and a history of vomiting and epigastric pain since the age of 4 years. Epigastric pain occurred during the day and in the evening and was worse after eating. In the late evening, the patient usually vomited part of his previous meal. His appetite was below normal because of a constant feeling of fullness. At physical examination the child was determined to be well developed. However, height and weight, which had been 1 SD below the mean during the first few years of life, were now more than 2 SDs below the mean. The abdomen was distended without enlarged organs. Bowel sounds were normal. Findings on contrast imaging studies of the esophagus, stomach, and proximal small bowel were initially reported as normal.At endoscopy, two slitlike openings were observed at the pylorus (Fig. 1). The openings failed to dilate during examination and an Olympus XP-240 (Olympus, Tokyo, Japan) endoscope (outer diameter, 7 mm) could not be passed through either opening. The mucosae of the stomach and the esophagus were normal. Because of these findings, the contrast imaging study was repeated with special attention to the pyloric area. During this subsequent examination (Fig. 2) two barium-filled channels were seen, one cephalad to the other. Only a minimal amount of barium entered the caudally located channel on the greater curvature side. This channel ended blindly in a cystlike structure. This cystlike structure had an extrinsic mass effect on the true channel, so only a minimal amount of barium could pass into the duodenum. Subsequent pyloric ultrasonography showed a region of low echo density near the proximal duodenum.At surgery, duplication of the pyloric channel was found. The caudally located channel, on the greater curvature side of the stomach, ended blindly. A cystlike structure was found in the wall of this channel. When the duodenum was opened along its convex aspect, the cystlike structure bulged into and partly obstructed the lumen of the true pyloric channel. Truncal vagotomy, antrectomy, and gastroduodenostomy (Billroth 1) were performed. The surgical specimen consisted of the gastric antrum resected in continuity with a centimeter of duodenal cuff. After surgery, the patient was able to eat well without epigastric pain and without bouts of vomiting. In addition, after a 1-year follow-up, height and weight had returned to −1 SD.Dissection of the surgical specimen showed a d...

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“…We identified five other patients with congenital double pylorus (Table 1) (3,4,(6)(7)(8). None had evidence of ulcer disease.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Gastric Diverticulum Containing Pancreatic Tissue and Presenting as Congenital Double Pylorus: Case Report and Review of the Literature

Wolters

Nikkels²,

Zee³

et al. 2001

Journal of Pediatric Gastroenterology and Nutrition

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show abstract

“…We identified five other patients with congenital double pylorus (Table 1) (3,4,6–8). None had evidence of ulcer disease.…”

Section: Discussionmentioning

confidence: 99%

A Gastric Diverticulum Containing Pancreatic Tissue and Presenting as Congenital Double Pylorus: Case Report and Review of the Literature

Wolters,

Nikkels,

Van Der Zee

et al. 2001

J. pediatr. gastroenterol. nutr.

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“…It has to be remembered that a dilated stornach with no gas in the distal bowel loops mayaiso be seen in gastrie hypotonia of the newborn (5). The beak sign is seen in eases ofantral duplieation (5), pylorie duplieation (5, 9), eongenital pylorie stenosis (5, 8) or duodenal duplieation eyst (2). In pylorie atresia, the beak sign is absent.…”

Section: Discussionmentioning

confidence: 99%

The Imaging Diagnosis of Pyloric Atresia

Grunebaum¹,

Kornreich²,

Ziv³

et al. 1985

Eur J Pediatr Surg

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Pyloric atresia is a congenital anomaly manifested by gastric outlet obstruction. The radiographic signs are characterised by the presence of the gas-bubble sign, the pyloric dimple sign and the absence of the beak sign. The differential diagnosis of these signs is discussed in view of other gastric outlet obstructions. Ultrasonography is of value in demonstrating the absence of the normal echo pattern of the pyloric muscle and the pyloric canal, thus confirming the diagnosis of pyloric atresia, or even may replace the fluoroscopy of the upper gastrointestinal tract.

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Congenital Double Pylorus

Cited by 33 publications

References 9 publications

A Gastric Diverticulum Containing Pancreatic Tissue and Presenting as Congenital Double Pylorus: Case Report and Review of the Literature

A Gastric Diverticulum Containing Pancreatic Tissue and Presenting as Congenital Double Pylorus: Case Report and Review of the Literature

A Gastric Diverticulum Containing Pancreatic Tissue and Presenting as Congenital Double Pylorus: Case Report and Review of the Literature

The Imaging Diagnosis of Pyloric Atresia

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