Abstract
Esophageal manometry was performed in 18 infants between 29 and 105 days of age with hypertrophic pyloric stenosis. Continuous 24-h esophageal pH monitoring was also carried out in 9 cases before and after pyloromyotomy in order to study lower esophageal sphincter (LES) function in infantile hypertrophic pyloric stenosis (IHPS). The mean preoperative pressure and length of the LES in IHPS were 9.30 mmHg and 1.30 cm respectively, which were significantly lower and shorter than those in controls (P <0.01), and gastroesophageal reflux was highly significant. The esophageal manometric studies showed that LES pressure increased markedly on the 7th postoperative day to 12.58 ± 2.56 mmHg and returned to normal values within 2 to 11 months after operation. The pH monitoring indicated that in most cases reflux had disappeared on the 7th postoperative day and the reflux parameter decreased from 8.34% to 3.34%. Our data suggest that most cases of IHPS (12/18) were accompanied by LES incompetence, but LES competence as a pressure barrier at the gastroesophageal junction became normal after operation.
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References
Benson CD (1962) Pediatric surgery. vol. 2. Year Book Medical Publishers, Chicago p 670
Bettex M, Oesch I (1983) The hiatus hernia saga: ups and downs in gastroesophageal reflux: past, present, and future perspectives. J Pediatr Surg 18: 670–680
Boix-Ochoa J, Lafuente JM, Gil-Vernet (1980) Twenty-four hour esophageal pH monitoring in gastroesophageal reflux. J Pediatr Surg 15: 74–78
Boix-Ochoa J (1986) Address of honored guest: the physiologic approach to the management of gastro-esophageal reflux. J. Pediatr Surg 21: 1032–1039
Comder LT, Farrell RL, Castell DO, McGuigan JE (1974) Measurements and comparisons of lower esophageal sphincter pressure and serum gastrin level in patients with GER. Gastroenterology 67: 415–422
Höllwarth ME, Uray E, Pesendorfer P, Rosanelli K, Rosegger H (1986) Esophageal manometry. Pediatr Surg Int 1: 177–183
Höllwarth ME, Uray E (1985) Physiology and pathophysiology of the esophagus in childhood. Prog Pediatr Surg 18: 1–14
Iwai N, Nanri M, Hashimoto K, Kaneda H, Majima S (1984) Serum gastrin level and lower esophageal sphincter pressures in infants with congenital hypertrophic pyloric stenosis. Z Kinderchir 39: 234–236
Koch AW (1986) Extended pH monitoring in the evaluation of gastroesophageal reflux in infancy and childhood. Pediatr Surg Int 1: 161–167
Koch A, Gass R (1981) Continuous 20–24 h esophageal pH monitoring in infancy. J Pediatr Surg 16: 109–113
Pellerin D, Bertin P, Tovar JA (1974) Reflux gastro-esophagien et stenose hypertrophique du pylore. Ann Chir Infant 15: 7–14
Sugurutake (1983) Studies of function of gastroesophageal junction in patients with IHPS. Jpn J Pediatr Surg 15: 63–72
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She, Yx., Shen, Zx. Lower esophageal sphincter function in infantile hypertrophic pyloric stenosis. Pediatr Surg Int 5, 336–338 (1990). https://doi.org/10.1007/BF00177100
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DOI: https://doi.org/10.1007/BF00177100