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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
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Pyloric stenosis: an enigma more than a century after the first successful treatment

Yousef El-Gohary1, Abdelhafeez Abdelhafeez1, Elizabeth Paton2

  • 1Department of Surgery, St. Jude Children's Research Hospital, 262 Danny Thomas Pl, Memphis, TN, 38105, USA.

Pediatric Surgery International
|October 15, 2017
PubMed

Insights

Hypertrophic pyloric stenosis (HPS) is common in infants, but its cause is unclear. Treatment has evolved to laparoscopic pyloromyotomy, with new insights into etiology and medical therapies like atropine sulfate.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Developmental Biology

Background:

  • Hypertrophic pyloric stenosis (HPS) is a frequent pediatric surgical condition with an incompletely understood etiology.
  • Understanding HPS is crucial for effective diagnosis and treatment strategies in infants.

Observation:

  • The review highlights the evolution of surgical techniques for HPS, culminating in the current standard: laparoscopic pyloromyotomy.
  • Key etiological theories include work-induced pyloric hypertrophy and associations with prokinetic macrolide antibiotics.

Findings:

  • Laparoscopic pyloromyotomy is the most common surgical approach for HPS.
  • Atropine sulfate is emerging as a potential medical treatment or rescue therapy for HPS and incomplete myotomies.

Implications:

  • Further research into HPS etiology may lead to preventative strategies.
  • Atropine sulfate offers a promising non-surgical or adjunctive treatment option, potentially reducing surgical intervention.
  • Advances in surgical and medical management improve outcomes for infants with HPS.

Keywords:
Laparoscopic pyloromyotomyMacrolidePyloric stenosisPyloromyotomy

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