Abstract
Adult idiopathic hypertrophic pyloric stenosis (AIHPS) is a misleading anatomic and radio-clinical entity of unknown etiology. Only about 200 cases have been reported in the literature. It is a benign disease resulting from hypertrophy of the circular fibers of the pyloric canal. Despite the recent progress in radiography and endoscopy, it is very hard to define hypertrophic stenosis in adults. Differentiation of primary from secondary pyloric stenosis is frequently a task of the pathologist rather than the surgeon. The main therapy is surgical, although endoscopic dilatation has been tried. There remains controversy over the best surgical approach. A case is reported of a 48-year-old male patient with AIHPS who was subjected to distal gastrectomy. This paper discusses the possible causes of the disorder, the recommended diagnostic steps, and the different surgical approaches.
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References
Dye TE, Vidals VG, Lockhart CE, Snider WR. Adult hypertrophic pyloric stenosis. Am Surg 1979;45(7):478–484.
MacDonald JA. Adult hypertrophic pyloric stenosis. Br J Surg 1973;60(1):73–75.
Thielemann H, Anders S, Naveke R, Diermann J. Primary hypertrophic pyloric stenosis. A rare form and stomach outlet stenosis in the adult. Zentralbl Chir 1999;124(10):947–949.
Kirklin BR, Harris MT. Hypertrophy of the pyloric muscle of adults: A distinctive roentgenologic sign. Am J Roentgenol 1933;29:437–442.
Ikenaga T, Honmyo U, Takano S, et al. Primary hypertrophic pyloric stenosis in the adult. J Gastroenterol Hepatol 1992;7(5):524–526.
Quigley RL, Pruitt SK, Pappas TN, Akwari O. Primary hypertrophic pyloric stenosis in the adult. Arch Surg 1990; 125(9):1219–1221.
Bateson EM, Talerman A, Walrond ER. Radiological and pathological observations in a series of seventeen cases of hypertrophic pyloric stenosis of adults. Br J Radiol 1969; 42(493):1–8.
Keynes WM. Simple and complicated hypertrophic pyloric stenosis in the adult. Gut 1965;6:240–252.
Balthazar EJ. Hypertrophic pyloric stenosis in adults: Radiographic features. Am J Gastroenterol 1983;78(7):449–453.
Dragstedt LR, Oberhelman HA Jr, Evans SO, Rigler SP. Antrum hyperfunction and gastric ulcer. Ann Surg 1954;140(3):396–404.
McClure CC. Hypertrophy of the pyloric muscle in adults. Surg Gynecol Obstet 1931;52:945–952.
Belding HH 3rd, Kernohan JW. A morphologic study of the myenteric plexus and musculature of the pylorus with special reference to the changes in hypertrophic pyloric stenosis. Surg Gynecol Obstet 1953;97(3):322–334.
Go TS, Morse WH. Hypertrophic pyloric stenosis in adults. Am J Gastroenterol 1973;60(4):400–405.
North JP, Johnson JH Jr. Pyloric hypertrophy in the adult. Ann Surg 1950;131(3):316–329.
Navab F, Flores L. Multinodular adult hypertrophic pyloric stenosis. J Clin Gastroenterol 1989;11(6):667–670.
Copleman B. Hypertrophy of the pyloric muscle in adults. Am J Gastroenterol 1962;37:650–655.
Kleitsch WP. Pyloric hypertrophy in the adult. Nebr State Med J 1953;38(3):87–89.
Twining EW. Chronic hypertrophic stenosis of the pylorus in adults. Br J Radiol 1933;6:644–655.
Schuster MM, Smith VM. The pyloric "cervix sign" in adult hypertrophic pyloric stenosis. Gastrointest Endosc 1970; 16(4):210–211.
Danikas D, Geis WP, Ginalis EM, Gorcey SA, Stratoulias C. Laparoscopic pyloroplasty in idiopathic hypertrophic pyloric stenosis in an adult. JSLS 2000;4(2):173–175.
Simson JN, Thomas AJ, Stoker TA. Adult hypertrophic pyloric stenosis and gastric carcinoma. Br J Surg 1986;73(5):379–380.
Brahos GJ, Mack E. Adult hypertrophic pyloric stenosis managed by double pyloroplasty. JAMA 1980;243(19):1928–1929.
Craver WL. Hypertrophic pyloric stenosis in adults. Gastroenterology 1957;33(6):914–924.
Graadt van Roggen JF, van Krieken JH. Adult hypertrophic pyloric stenosis: Case report and review. J Clin Pathol 1998; 51(6):479–480.
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Hellan, M., Lee, T. & Lerner, T. Diagnosis and therapy of primary hypertrophic pyloric stenosis in adults: Case report and review of literature. J Gastrointest Surg 10, 265–269 (2006). https://doi.org/10.1016/j.gassur.2005.06.003
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DOI: https://doi.org/10.1016/j.gassur.2005.06.003