Pyloric stenosis - is a congenital or acquired disease of the pylorus - the output of the stomach resulting from congenital malformation, an organic lesion of the muscles, their scar deformations or chemical burn pyloric.
Pyloric stenosis is more often occurs in children as a congenital anomaly in the first weeks of life. This disease is difficult and without the timely operation can lead to death of the child.
Pyloric stenosis in adults is usually the result of progressive running pilorospazmeOr it is the result of extensive scarring ulcers or burns in the gatekeeper.
Causes
The causes of pyloric stenosis in adults are similar to those in the secondary pilorospazme, but usually occur with long-term and running process, when the muscles are completely lose their functionality and become dense connective the cloth.
The main reasons are:
- peptic ulcerEspecially when ulcers are located in the area of the pylorus,
- chronic gastritisEspecially with high acidity,
- inflammation in the outlet area of the stomach and intestines department entry (piloroduodenit)
- polyposis of the stomach or bowel,
- various digestive diseases department - colitisPolyposis colon, Crohn's disease appendicitis or chronic, resulting in surplus of pathological pulses generated constant spasm pyloric stenosis in the transition,
- biliary tract disease and adhesions, for the same reasons - abnormal impulses from bodies (sick bodies provide extremely strong signals that give a reflex muscle spasm Gatekeeper).
Development of pyloric stenosis in children
The causes of pyloric stenosis in children is unknown. Leading to its development are:
- adverse pregnancy with severe toxicosis in the early Rocky,
- carried in the early stage of viral infection,
- mother endocrine disorders,
- taking certain medications.
In this case, as a result of violations of bookmarks in the stomach pyloric part of the muscle or almost all of the pyloric section of the stomach is replaced dense and non-stretch the connective tissue and the outlet from the stomach is sharply narrowed down to a microscopically thin holes.
Manifestations of pyloric stenosis in adults
Pyloric stenosis in adults tends to progression. This gives rise to the symptoms:
- difficulty in the passage of food from the stomach into the intestine at a constant weight in the stomach and nausea after eating,
- pain after eating, colicky or Expander nature,
- vomiting, bring relief, especially when abundant food or taking solid food,
- constant burping,
- progressive weight loss and breach of the general state of health,
- signs of vitamin and mineral deficiency.
There are three degrees of pyloric stenosis:
- compensated form is manifested only a feeling of fullness and episodic vomiting scant at the slightest error in the diet,
- subcompensated form gives vomiting attacks, the nature of a more abundant and stagnant, the food is in the stomach for a long time,
- under the form of uncompensated patients themselves cause vomiting as food almost does not pass into the intestines, rotting in the stomach and cause pain and discomfort.
He joins a strong thinness and signs of dehydration.
Symptoms in children
Pyloric stenosis occurs more often in boys. Symptoms appear 2-3 weeks of life and progressively strengthened.
Such manifestations are usually:
- vomiting fountain constantly increasing, without admixture of bile
- the amount of milk by vomiting is equal to or greater than it was eaten,
- first onset emesis occurs within 15 minutes after eating, gradually interval between meals and vomiting increased, vomit acidic smell,
- progressively increases weight loss,
- revealed signs of dehydration,
- It stands little concentrated urine,
- chair lean and "dry"
- standing constipation.
Diagnostics
In children, the basis of the diagnosis - increasing symptoms and examination of data - the stomach becomes like an hourglass, the West in the stomach.
But in addition it is necessary to confirm the diagnosis conducting X-ray with contrast suspension.
The blood tests raised hemoglobin due to blood clots and slowed ESR, in biochemical analysis of reduced and the amount of sodium chloride due to vomiting.
In adults, the data is also based on the X-ray with contrast, but supplemented with data fibrogastroscopyAt which visually detected narrowed pylorus and scars, or thick strands instead of muscle.
It is important to distinguish between pilorospazm and pyloric stenosis, as pilorospazm does not require surgery, as opposed to the stenosis.
treatment of pyloric stenosis
Pyloric stenosis treated with surgery.
The main treatment is surgery for dissecting narrowed pylorus and plastic, to form a hole normal size.
Pre patient is prepared for surgery in 1-3 days, injecting intravenously solutions of glucose and electrolytes for correction of dehydration and starvation.
In adult patients with ulcerative lesions or tumors, can make partial gastric resection with plastic outlet.
In all other cases, and children are trying to keep the stomach full, only cutting the narrowed pylorus and forming its normal opening.
After the operation is carried out with a gradual rehabilitation first feeding small volumes by increasing them to physiological.
In children after surgery is usually not the consequences, they develop normally. In adults, predictions depend on what caused the cause of pyloric stenosis.
