Estenosis hipertrófica pilórica del adulto

Gastric outlet obstruction secondary to adult hypertrophic pyloric stenosis: case report and literature review

“…The most universally accepted classifications are those of Danikas et al, and Zarineh et al classified AHPS into three types: type 1, which is childhood AHPS diagnosed at a late stage; type 2, which is the most common type, which occurs during adult life and is probably secondary to underlying gastrointestinal pathologies, such as peptic ulcer, malignant tumors and certain inflammatory diseases; and type 3, which is idiopathic adult-onset AHPS. 9,10 Zarineh et al divided AHPS into primary, which has no underlying cause and under which idiopathic AHPS would be classified, and secondary, caused by an underlying disorder such as excessive healing of gastric or duodenal ulcers, malignant tumors, GISTs, postoperative intraabdominal adhesions, bezoars, and increased vagal activity, causing hypertrophy of the pylorus. 2 The secondary type of AHPS usually demonstrates predominantly localized replacement by fibrous tissue, with little or no smooth muscle hypertrophy.…”

“…The clinical symptoms of idiopathic AHPS are like the clinical symptoms of gastric outlet obstruction induced by other causes including epigastralgia, early satiety, and postprandial nausea or vomiting. 1,[4][5][6]10 The exact etiology of AHPS is unclear, and it is usually difficult to diagnose AHPS before surgical resection.…”

“…7 Asymptomatic patients or patients with minimal symptoms do not require treatment while patients with clinical evidence require surgical treatment. 10 Multiple treatments have been proposed for AHPS, including endoscopic dilation, pyloromyotomy with or without pyloroplasty, and gastrectomy with Billroth I gastroduodenostomy. 2,[4][5][6] Among the various surgical techniques, pylorectomy with minimal gastrectomy is the one that seems to obtain the best results.…”

“…2,[4][5][6] Among the various surgical techniques, pylorectomy with minimal gastrectomy is the one that seems to obtain the best results. 5,10 Most authors favor a limited distal gastric resection with Billroth I or II anastomosis. This technique is especially recommended if the pylorus wall is very thick, making pyloroplasty technically difficult.…”

Estenosis hipertrófica pilórica de presentación tardía

“…5 Hay algunos reportes de esta entidad en adolescentes y adultos, aunque su frecuencia es mucho menor. 7,8 El paciente presentó sintomatología durante tres semanas, en un inicio fue diagnosticado con una gastroenteritis (vómitos y diarrea) que mejoró parcialmente con tratamiento médico. La edad de nuestro paciente hacía improbable pensar en una EHP des-de un inicio.…”