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Congenital pyloric atresia--a report of two cases
Insights
Surgical intervention is crucial for membranous pyloric atresia. Procedures like diaphragm excision/incision with pyloroplasty and gastroduodenostomy are recommended, avoiding gastrojejunostomy due to high mortality.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Pyloric atresia is a rare congenital anomaly.
- Membranous pyloric atresia requires specific surgical approaches.
Observation:
- Two cases of membranous pyloric atresia were treated with diaphragm excision/incision and pyloroplasty.
- A literature review of 99 cases was conducted.
Findings:
- One patient survived after gastroduodenostomy for postoperative stenosis.
- A premature infant died from sepsis on the 58th postoperative day.
- Surgical treatment choice depends on the type of pyloric atresia.
Implications:
- Excision/incision of the diaphragm with pyloroplasty and gastroduodenostomy are preferred surgical procedures.
- Gastrojejunostomy is associated with a high mortality rate and should be avoided.
Abstract:
Two cases of the membranous type of pyloric atresia are described and a review of 99 cases reported in the literature is presented. Excision and incision of diaphragm with pyloroplasty was performed on both cases. The first patient was alive following the second operation of gastroduodenostomy for postoperative stenosis. The second premature patient died of sepsis on the 58th postoperative day. The treatment should be surgical and the operative procedure should be chosen depending on the type of atresia. Excision or incision of the diaphragm with pyloroplasty and gastroduodenostomy are the procedures of choice. Gastrojejunostomy should be avoided because of its high mortality rate.