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World Journal of Surgery 1993In an attempt to prevent the sequelae of conventional gastrectomy, such as rapid gastric emptying, dumping syndrome, intestinal content reflux, indigestion, and poor...
In an attempt to prevent the sequelae of conventional gastrectomy, such as rapid gastric emptying, dumping syndrome, intestinal content reflux, indigestion, and poor absorption, we have devised the pylorus and pyloric vagus preserving gastrectomy (PPVPG). Experimenting on 48 dogs, we found theoretic grounds for using our design and obtained the desired effects--retaining the merits of conventional subtotal resection of the stomach, with acidity reduction, while avoiding the above-mentioned complications.
Topics: Animals; Dogs; Electromyography; Gastrectomy; Postoperative Complications; Pylorus; Vagus Nerve
PubMed: 8362530
DOI: 10.1007/BF01655114 -
Deutsche Medizinische Wochenschrift... Feb 2012A 58-year-old man was admitted for elucidation of a microcytic anemia diagnosed by his general practitioner (hemoglobin of 5,5 g/dl). He felt dizzy and unwell. The...
HISTORY AND ADMISSION FINDINGS
A 58-year-old man was admitted for elucidation of a microcytic anemia diagnosed by his general practitioner (hemoglobin of 5,5 g/dl). He felt dizzy and unwell. The patient had for some time been regularly taking 1-2 tablets of diclofenac, a nonsteroid anti-inflammatory drug (NSAID), for joint and gouty pain. He had occasionally noted small amounts of blood on his stool. The physical examination was unremarkable except for obesity, several swollen and painful joints, and a gouty right big toe with a tophus and small ulcer.
INVESTIGATIONS
Coloscopy revealed extensive multiple aphthous ulcers throughout the colon (histologically diagnosed as NSAID colopathy). Esophagogastroduodenoscopy failed to identify a source of bleeding. But it also revealed a double pylorus, which was divided into two equal parts by a smooth, pencil-thick circular band, but fully patent and without inflammatory changes or scarring.
TREATMENT AND COURSE
Several erythrocyte units were infused, which stabilized the patient's condition. There was no evidence of renewed bleeding. But subsequently he experienced severe joint pain, the CPR rising to 252.31 mg/dl. Administration of steroids, novaminsulfon and opioids, as well as uric acid lowering drugs gradually improved the joint pain and enabled physiotherapy to improve mobility and the patient was discharged home.
CONCLUSION
Congenital abnormalities are rarely found during gastrointestinal endoscopy in adults. Very rare are duplications of the pyloric channel most of which are acquired by ulcer perforation. In general, congenital double pylorus is mainly a harmless incidental finding which needs no therapy, but it should be distinguished from acquired double pylorus. Endoscopists should be aware of this abnormality to avoid complications during side-view endoscopy.
Topics: Endoscopy, Gastrointestinal; Humans; Incidental Findings; Male; Middle Aged; Pylorus
PubMed: 22334362
DOI: 10.1055/s-0031-1298951 -
The American Surgeon Feb 2011
Topics: Digestive System Surgical Procedures; Female; Humans; Infant, Newborn; Polyhydramnios; Pregnancy; Pylorus; Ultrasonography
PubMed: 21337899
DOI: No ID Found -
MMW, Munchener Medizinische... Jan 1976Two cases of double pylorus are reported which had been diagnosed gastroscopically. In 1 case, the ulcerative origin could be demonstrated by autopsy and histological...
Two cases of double pylorus are reported which had been diagnosed gastroscopically. In 1 case, the ulcerative origin could be demonstrated by autopsy and histological examination.
Topics: Congenital Abnormalities; Gastroscopy; Humans; Male; Middle Aged; Pyloric Stenosis; Pylorus; Radiography
PubMed: 814433
DOI: No ID Found -
Gastroenterologie Clinique Et Biologique 1977
Topics: Humans; Pylorus; Stomach Ulcer
PubMed: 892331
DOI: No ID Found -
Surgery Jun 2003Pylorus-preserving gastrectomy (PPG) is a function-preserving surgery; however, long-term retention of food in the residual stomach is a frequent complication during the...
BACKGROUND
Pylorus-preserving gastrectomy (PPG) is a function-preserving surgery; however, long-term retention of food in the residual stomach is a frequent complication during the early postoperative period. We reported that gastric stasis after PPG was attributable to the delayed recovery of gastric phase III, in which pyloric relaxation accompanied a contraction of the gastric body. The objective of the present study is to determine whether erythromycin can induce phase III with pyloric relaxation after PPG.
METHODS
We studied gastrointestinal motility in dogs after PPG by using strain gauge force transducer. After randomized administration of either erythromycin or saline, interdigestive gastropyloroduodenal motility was recorded.
RESULTS
Erythromycin induced phase III with pyloric relaxation in the early postoperative period. Pyloric relaxation accompanied a contraction of the gastric body. Compared with the saline group (body: 87.2 +/- 16.7 mmHg x min, antrum: 69.7 +/- 13.7 mmHg x min, pylorus: 91.7 +/- 22.1 mmHg x min), the erythromycin group showed significantly increased gastropyloric motility indexes (body: 506.2 +/- 33.5 mmHg x min, antrum: 430.9 +/- 53.7 mmHg x min, pylorus: 589.5 +/- 59.5 mmHg x min).
CONCLUSIONS
Erythromycin can induce phase III, in which pyloric relaxation accompanied a contraction of the gastric body in the early postoperative period after PPG. Erythromycin might be used as a prokinetic agent for the treatment of early gastric stasis after PPG.
Topics: Animals; Atropine; Dogs; Erythromycin; Gastrectomy; Gastric Emptying; Gastrointestinal Motility; Muscle Contraction; Pylorus; Stomach
PubMed: 12796733
DOI: 10.1067/msy.2003.165 -
Japanese Journal of Pharmacology Oct 1975
Comparative Study
Topics: Animals; Dose-Response Relationship, Drug; Gastric Juice; Ligation; Male; Pepsin A; Plant Extracts; Pylorus; Rats
PubMed: 768564
DOI: 10.1254/jjp.25.608 -
Journal of Smooth Muscle Research =... Dec 1995
Topics: Animals; Dogs; Erythromycin; Female; Gastrointestinal Motility; Male; Models, Biological; Pancreaticoduodenectomy; Pylorus
PubMed: 8867940
DOI: No ID Found -
Canadian Journal of Surgery. Journal... Sep 1981It is difficult to decide on the best method of management for the double-channel pylorus because there is no agreement as to whether this uncommon condition is...
It is difficult to decide on the best method of management for the double-channel pylorus because there is no agreement as to whether this uncommon condition is congenital or acquired. Of 60 cases reported in the literature 55 were associated with peptic ulcer disease strongly suggesting an acquired origin. A congenital origin should be accepted only if specific criteria obtain: (a) presence in early childhood, (b) presence of mucous, lamina propria and muscularis mucosae on microscopic examination and (c) characteristic findings as fluoroscopic examination. The authors report three patients with a double-channel pylorus. In one a prepyloric ulcer immediately preceded the development of the false antroduodenal channel. The other patients had peptic ulcer disease. All were treated conservatively. Operation is unnecessary except for complications that may arise. The authors' cases demonstrate that unless the diagnosis of double-channel pylorus is considered the radiologic and endoscopic findings may be misinterpreted.
Topics: Aged; Female; Humans; Male; Middle Aged; Peptic Ulcer; Pylorus; Radiography; Stomach Diseases
PubMed: 7284920
DOI: No ID Found -
Khirurgiia Apr 1992The article analyses the results of pylorus-preserving resections of the stomach in 116 patients among whom 80 had gastric ulcer, 29 ad duodenal ulcer, and 7 had...
The article analyses the results of pylorus-preserving resections of the stomach in 116 patients among whom 80 had gastric ulcer, 29 ad duodenal ulcer, and 7 had gastroduodenal ulcers. Changes of acidity and motor-evacuation function of the gastric stump were studied according to the method of pylorus-preserving resection. The late-term results of treatment in follow-up periods of 2 to 5 years are shown, they were found to be good in 96.6% of patients treated by operation and poor in 1.7%. It is noted that the function of the gastric stump is better when the vagus innervation of the pylorus is preserved. Mediogastric resection with selective proximal vagotomy in patients suffering from duodenal ulcer with a superacidic stomach led to stable normalization of acid production, which was a reliable measure for the prevention of a recurrent ulcer.
Topics: Adult; Aged; Female; Gastrectomy; Gastric Acidity Determination; Gastric Emptying; Humans; Hydrogen-Ion Concentration; Male; Middle Aged; Peptic Ulcer; Postoperative Period; Pylorus
PubMed: 1447878
DOI: No ID Found