Document Detail

The development of hypertrophic pyloric stenosis in a patient with prostaglandin-induced foveolar hyperplasia.
MedLine Citation:
PMID:  10525782     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Hypertrophic pyloric stenosis (HPS) has been described in association with several obstructive antropyloric lesions including idiopathic foveolar hyperplasia (gastric mucosal hypertrophy), feeding tubes, eosinophilic gastroenteritis, and hypertrophic antral polyps. Non obstructive antral webs have also been described with HPS. PATIENT AND METHODS: We present a case of gastric-outlet obstruction in association with HPS, namely, prostaglandin-induced foveolar hyperplasia. This entity has been previously described, but rarely in association with HPS. We report a female infant requiring prostaglandin therapy for pulmonary atresia who developed dose-related prostaglandin-induced foveolar hyperplasia and symptoms of progressive non-bilious vomiting. RESULTS: Initially, ultrasonography demonstrated evidence of antral mucosal hypertrophy as the cause for gastric-outlet obstruction. The patient subsequently developed progressive thickening of the antropyloric muscle, resulting in sonographic appearances of hypertrophic pyloric stenosis. Pyloromyotomy was eventually required for treatment of HPS. CONCLUSION: A common denominator of most of the above-described entities is thickening and/or hypertrophy of the antral mucosa. We suggest that the antropyloric musculature may hypertrophy in an effort to overcome the gastric-outlet obstruction caused by the adjacent thickened antral mucosa. In other words, these entities may represent examples of "secondary" hypertrophic pyloric stenosis.
M J Callahan; R G McCauley; H Patel; Z M Hijazi
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pediatric radiology     Volume:  29     ISSN:  0301-0449     ISO Abbreviation:  Pediatr Radiol     Publication Date:  1999 Oct 
Date Detail:
Created Date:  1999-11-09     Completed Date:  1999-11-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0365332     Medline TA:  Pediatr Radiol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  748-51     Citation Subset:  IM    
New England Medical Center, Tufts University School of Medicine, Department of Radiology, 750 Washington Street, Boston, MA 02111, USA.
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MeSH Terms
Gastric Mucosa / pathology
Gastric Outlet Obstruction / diagnosis,  etiology*,  ultrasonography
Hypertrophy / chemically induced,  ultrasonography
Infant, Newborn
Prostaglandins / adverse effects*,  therapeutic use
Pulmonary Atresia / drug therapy
Pyloric Antrum / pathology*,  ultrasonography
Pyloric Stenosis / diagnosis,  etiology*,  ultrasonography
Reg. No./Substance:

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