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Idiopathic non-hypertrophic pyloric stenosis in an infant successfully treated via endoscopic approach.
MedLine Citation:
PMID:  21191516     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Non-peptic, non-hypertrophic pyloric stenosis has rarely been reported in pediatric literature. Endoscopic pyloric balloon dilation has been shown to be a safe procedure in treating gastric outlet obstruction in older children and adults. Partial gastric outlet obstruction (GOO) was diagnosed in an infant by history and confirmed by an upper gastrointestinal series (UGI). Abdominal ultrasonography and computed tomography scan excluded idiopathic hypertrophic pyloric stenosis, abdominal tumors, gastrointestinal and hepato-biliary-pancreatic anomalies. Endoscopic findings showed a pinhole-sized pylorus and did not indicate peptic ulcer disease, Helicobacter pylori infection, antral web, or evidence of allergic and inflammatory bowel diseases. Three sessions of a step-wise endoscopic pyloric balloon dilation were conducted under general anesthesia and a fluoroscopy at two week intervals using catheter balloons (Boston Scientific Microvasive(®), MA, USA) of increasing diameters. Repeat UGI after the first session revealed normal gastrointestinal transit and no intestinal obstruction. The patient tolerated solid food without any gastrointestinal symptoms since the first session. The endoscope was able to be passed through the pylorus after the last session. Although the etiology of GOO in this infant is unclear (proposed mechanisms are herein discussed), endoscopic pyloric balloon dilation was a safe procedure for treating this young infant with non-peptic, non-hypertrophic pyloric stenosis and should be considered as an initial approach before pyloroplasty in such presentations.
Authors:
Wikrom Karnsakul; Mary L Cannon; Stacey Gillespie; Richard Vaughan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of gastrointestinal endoscopy     Volume:  2     ISSN:  1948-5190     ISO Abbreviation:  World J Gastrointest Endosc     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-30     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101532474     Medline TA:  World J Gastrointest Endosc     Country:  China    
Other Details:
Languages:  eng     Pagination:  413-6     Citation Subset:  -    
Affiliation:
Wikrom Karnsakul, Division of Pediatric Gastroenterology and Nutrition, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United State.
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