Skip to main content

Advertisement

Log in

New insights into the pathogenesis of infantile pyloric stenosis

  • Review Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Infantile hypertrophic pyloric stenosis (IHPS) is the most common surgical cause of vomiting in infants. Despite numerous hypotheses, the aetiopathogenesis of IHPS is not fully understood. Genetic, extrinsic and hormonal factors have been implicated in the pathogenesis of the disease. Furthermore, abnormalities of various components of the pyloric muscle such as smooth muscle cells, growth factors, extracellular matrix elements, nerve and ganglion cells, synapses, nerve supporting cells, neurotransmitters and interstitial cells of Cajal have been reported. Recently, genetic studies have identified susceptibility loci for IHPS and molecular studies have concluded that smooth muscle cells are not properly innervated in IHPS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Abel RM (1996) The ontogeny of the peptide innervation of the human pylorus, with special reference to understanding the aetiology and pathogenesis of infantile hypertrophic pyloric stenosis. J Pediatr Surg 31(4):490–497

    CAS  PubMed  Google Scholar 

  2. Abel RM (2000) Hunterian Lecture. The ontogeny of the peptide innervation of the human pylorus with special reference to understanding the aetiology and pathogenesis of infantile hypertrophic pyloric stenosis. Ann R Coll Surg Engl 82(6):371–377

    CAS  PubMed  Google Scholar 

  3. Alarotu H (1956) The histopathologic changes in the myenteric plexus of the pylorus in hypertrophic pyloric stenosis of infants (pylorospasm). Acta Paediatr Suppl 45(Suppl 107):1–131

    CAS  PubMed  Google Scholar 

  4. Applegate MS, Druschel CM (1995) The epidemiology of infantile hypertrophic pyloric stenosis in New York State, 1983 to 1990. Arch Pediatr Adolesc Med 149(10):1123–1129

    CAS  PubMed  Google Scholar 

  5. Barbosa IM, Ferrante SM et al (2001) Role of nitric oxide synthase in the etiopathogenesis of hypertrophic pyloric stenosis in infants. J Pediatr (Rio J) 77(4):307–312

    Google Scholar 

  6. Belding HH, Kernohan JW (1953) A morphological study of the myenteric plexus with special reference to changes in hypertrophic pyloric stenosis. Surg Gynecol Obstet 97:323–334

    Google Scholar 

  7. Bleicher MA, Shandling B et al (1978) Increased serum immunoreactive gastrin levels in idiopathic hypertrophic pyloric stenosis. Gut 19(9):794–797

    CAS  PubMed  Google Scholar 

  8. Callahan MJ, McCauley RG et al (1999) The development of hypertrophic pyloric stenosis in a patient with prostaglandin-induced foveolar hyperplasia. Pediatr Radiol 29(10):748–751

    CAS  PubMed  Google Scholar 

  9. Capon F, Reece A et al (2006) Linkage of monogenic infantile hypertrophic pyloric stenosis to chromosome 16p12-p13 and evidence for genetic heterogeneity. Am J Hum Genet 79(2):378–382

    CAS  PubMed  Google Scholar 

  10. Carter CO (1961) The inheritance of congenital pyloric stenosis. Br Med Bull 17(3):251–254

    CAS  PubMed  Google Scholar 

  11. Carter CO, Evans KA (1969) Inheritance of congenital pyloric stenosis. J Med Genet 6:233–254

    CAS  PubMed  Google Scholar 

  12. Cass DT, Zhang AL (1991) Extracellular matrix changes in congenital hypertrophic pyloric stenosis. Pediatr Surg Int 6:190–194

    Google Scholar 

  13. Cekada S, Kilvain S et al (1999) Partial trisomy 13q22–>qter and monosomy 18q21–>qter as a result of familial translocation. Acta Paediatr 88(6):675–678

    CAS  PubMed  Google Scholar 

  14. Choi KM, Gibbons SJ et al (2007) Regulation of interstitial cells of Cajal in the mouse gastric body by neuronal nitric oxide. Neurogastroenterol Motil 19(7):585–595

    CAS  PubMed  Google Scholar 

  15. Chung E, Curtis D et al (1996) Genetic evidence for the neuronal nitric oxide synthase gene (NOS1) as a susceptibility locus for infantile pyloric stenosis. Am J Hum Genet 58(2):363–370

    CAS  PubMed  Google Scholar 

  16. Cooper WO, Griffin MR et al (2002) Very early exposure to erythromycin and infantile hypertrophic pyloric stenosis. Arch Pediatr Adolesc Med 156(7):647–650

    PubMed  Google Scholar 

  17. Cooper WO, Ray WA et al (2002) Prenatal prescription of macrolide antibiotics and infantile hypertrophic pyloric stenosis. Obstet Gynecol 100(1):101–106

    PubMed  Google Scholar 

  18. Dahshan A, Donovan KG et al (2006) Helicobacter pylori and infantile hypertrophic pyloric stenosis: is there a possible relationship? J Pediatr Gastroenterol Nutr 42(3):262–264

    PubMed  Google Scholar 

  19. Daniel EE, Tomita T et al (1992) Sphincters: normal function-changes in diseases. CRC press, Boca Raton

  20. Danzer E, Schier F et al (2000) Smith-Lemli-Opitz Syndrome: case report and literature review. J Pediatr Surg 35(12):1840–1842

    CAS  PubMed  Google Scholar 

  21. Dick AC, Ardill J et al (2001) Gastrin, somatostatin and infantile hypertrophic pyloric stenosis. Acta Paediatr 90(8):879–882

    CAS  PubMed  Google Scholar 

  22. Dieler R, Schroder JM et al (1990) Infantile hypertrophic pyloric stenosis: myopathic type. Acta Neuropathol 80(3):295–306

    CAS  PubMed  Google Scholar 

  23. Dodge JA (1970) Production of duodenal ulcers and hypertrophic pyloric stenosis by administration of pentagastrin to pregnant and newborn dogs. Nature 225(5229):284–285

    CAS  PubMed  Google Scholar 

  24. Dodge JA (1996) Study of breast feeding and hypertrophic pyloric stenosis does not conflict with others. BMJ 312(7047):1674

    CAS  PubMed  Google Scholar 

  25. Everett KV, Capon F et al (2008) Linkage of monogenic infantile hypertrophic pyloric stenosis to chromosome 16q24. Eur J Hum Genet 16(9):1151–1154

    CAS  PubMed  Google Scholar 

  26. Everett KV, Chioza BA et al (2008) Genome-wide high density SNP-based linkage analysis of infantile hypertrophic pyloric stenosis identifies loci on chromosomes 11q14-q22 and Xq23. Am J Hum Genet 82:756–762

    CAS  PubMed  Google Scholar 

  27. Farrugia G, Szurszewski JH (1999) Heme oxygenase, carbon monoxide, and interstitial cells of Cajal. Microsc Res Tech 47(5):321–324

    CAS  PubMed  Google Scholar 

  28. Finsen VR (1979) Infantile hypertrophic pyloric stenosis—unusual familial incidence. Arch Dis Child 54(9):720–721

    CAS  PubMed  Google Scholar 

  29. Friesen SR, Boley JO et al (1956) The myenteric plexus of the pylorus: its early normal development and its changes in hypertrophic pyloric stenosis. Surgery 39(1):21–29

    CAS  PubMed  Google Scholar 

  30. Gentile C, Romeo C et al (1998) A possible role of the plasmalemmal cytoskeleton, nitric oxide synthase, and innervation in infantile hypertrophic pyloric stenosis. A confocal laser scanning microscopic study. Pediatr Surg Int 14(1–2):45–50

    CAS  PubMed  Google Scholar 

  31. Grochowski J, Szafran H et al (1980) Blood serum immunoreactive gastrin level in infants with hypertrophic pyloric stenosis. J Pediatr Surg 15(3):279–282

    CAS  PubMed  Google Scholar 

  32. Guarino N, Shima H et al (2000) Glial-derived growth factor signaling pathway in infantile hypertrophic pyloric stenosis. J Pediatr Surg 35(6):835–839

    CAS  PubMed  Google Scholar 

  33. Guarino N, Shima H et al (2000) Structural immaturity of the pylorus muscle in infantile hypertrophic pyloric stenosis. Pediatr Surg Int 16(4):282–284

    CAS  PubMed  Google Scholar 

  34. Guarino N, Yoneda A et al (2001) Selective neurotrophin deficiency in infantile hypertrophic pyloric stenosis. J Pediatr Surg 36(8):1280–1284

    CAS  PubMed  Google Scholar 

  35. Hambourg MA, Mignon M et al (1979) Serum gastrin levels in hypertrophic pyloric stenosis of infancy. Response to a gastrin secretion test. Arch Dis Child 54(3):208–212

    CAS  PubMed  Google Scholar 

  36. Hanquinet S, Damry N et al (1995) Gastric outlet obstruction: unusual ultrasonographic findings in the pyloric and antral regions. Pediatr Radiol 25(Suppl 1):S163–S166

    PubMed  Google Scholar 

  37. Heller A, Seidel J et al (2000) Molecular cytogenetic characterisation of partial trisomy 9q in a case with pyloric stenosis and a review. J Med Genet 37(7):529–532

    CAS  PubMed  Google Scholar 

  38. Hodgson SV, Berry AC et al (1995) Two brothers with an unbalanced 8;17 translocation and infantile pyloric stenosis. Clin Genet 48(6):328–330

    CAS  PubMed  Google Scholar 

  39. Holland AJ, Freeman JK et al (1997) Idiopathic focal foveolar hyperplasia in infants. Pediatr Surg Int 12(7):497–500

    CAS  PubMed  Google Scholar 

  40. Huang LT, Tiao MM et al (2006) Low plasma nitrite in infantile hypertrophic pyloric stenosis patients. Dig Dis Sci 51(5):869–872

    CAS  PubMed  Google Scholar 

  41. Huang PL, Dawson TM et al (1993) Targeted disruption of the neuronal nitric oxide synthase gene. Cell 75(7):1273–1286

    CAS  PubMed  Google Scholar 

  42. Huizinga JD (2001) Physiology and pathophysiology of the intersitial cell of cajal: from bench to bedside II. Gastric motility: lessons from mutant mice on slow waves and innervation. Am J Physiol Gastrointest Liver Physiol 281:1129–1134

    Google Scholar 

  43. Hummer-Ehret BH, Rohrschneider WK et al (1998) Eosinophilic gastroenteritis mimicking idiopathic hypertrophic pyloric stenosis. Pediatr Radiol 28(9):711–713

    CAS  PubMed  Google Scholar 

  44. Iino S, Horiguchi K (2006) Interstitial cells of cajal are involved in neurotransmission in the gastrointestinal tract. Acta Histochem Cytochem 39(6):145–153

    CAS  PubMed  Google Scholar 

  45. Jablonski J, Gawronska R et al (2006) Study of insulin-like growth factor-1 (IGF-1) and platelet-derived endothelial cell growth factor (PDEGF) expression in children with infantile hypertrophic pyloric stenosis. Med Sci Monit 12(1):CR27–CR30

    CAS  PubMed  Google Scholar 

  46. Jackson L, Kline AD et al (1993) de Lange syndrome: a clinical review of 310 individuals. Am J Med Genet 47(7):940–946

    CAS  PubMed  Google Scholar 

  47. Jona JZ (1978) Electron microscopic observations in infantile hypertrophic pyloric stenosis (IHPS). J Pediatr Surg 13(1):17–20

    CAS  PubMed  Google Scholar 

  48. Kim S, Chung CJ et al (1997) Coexisting hyperplastic antral polyp and hypertrophic pyloric stenosis. Pediatr Radiol 27(12):912–914

    CAS  PubMed  Google Scholar 

  49. Kobayashi H, Miyahara K et al (2001) Pyloric stenosis: new histopathologic perspective using confocal laser scanning. J Pediatr Surg 36(8):1277–1279

    CAS  PubMed  Google Scholar 

  50. Kobayashi H, O’Briain DS et al (1994) Defective cholinergic innervation in pyloric muscle of patients with hypertrophic pyloric stenosis. Pediatr Surg Int 9:338–341

    Google Scholar 

  51. Kobayashi H, O’Briain DS et al (1994) Selective reduction in intramuscular nerve supporting cells in infantile hypertrophic pyloric stenosis. J Pediatr Surg 29(5):651–654

    CAS  PubMed  Google Scholar 

  52. Kobayashi H, O’Briain DS et al (1995) Immunochemical characterization of neural cell adhesion molecule (NCAM), nitric oxide synthase, and neurofilament protein expression in pyloric muscle of patients with pyloric stenosis. J Pediatr Gastroenterol Nutr 20(3):319–325

    CAS  PubMed  Google Scholar 

  53. Kobayashi H, Wester T et al (1997) Age-related changes in innervation in hypertrophic pyloric stenosis. J Pediatr Surg 32(12):1704–1707

    CAS  PubMed  Google Scholar 

  54. Komuro T (2006) Structure and organization of interstitial cells of Cajal in the gastrointestinal tract. J Physiol 576(Pt 3):653–658

    CAS  PubMed  Google Scholar 

  55. Kusafuka T, Puri P (1997) Altered messenger RNA expression of the neuronal nitric oxide synthase gene in infantile hypertrophic pyloric stenosis. Pediatr Surg Int 12(8):576–579

    CAS  PubMed  Google Scholar 

  56. LaFerla G, Watson J et al (1986) The role of prostaglandins E2 and F2 alpha in infantile hypertrophic pyloric stenosis. J Pediatr Surg 21(5):410–412

    CAS  PubMed  Google Scholar 

  57. Langer JC, Berezin I et al (1995) Hypertrophic pyloric stenosis: ultrastructural abnormalities of enteric nerves and the interstitial cells of Cajal. J Pediatr Surg 30(11):1535–1543

    CAS  PubMed  Google Scholar 

  58. Latchaw LA, Jacir NN et al (1989) The development of pyloric stenosis during transpyloric feedings. J Pediatr Surg 24(8):823–824

    CAS  PubMed  Google Scholar 

  59. Louik C, Mitchell AA (2003) Prenatal prescription of macrolide antibiotics and infantile hypertrophic pyloric stenosis. Obstet Gynecol 101(4):816 author reply 816-7

    PubMed  Google Scholar 

  60. MacMahon B (2006) The continuing enigma of pyloric stenosis of infancy: a review. Epidemiology 17(2):195–201

    PubMed  Google Scholar 

  61. Mahon BE, Rosenman MB et al (2001) Maternal and infant use of erythromycin and other macrolide antibiotics as risk factors for infantile hypertrophic pyloric stenosis. J Pediatr 139(3):380–384

    CAS  PubMed  Google Scholar 

  62. Malmfors G, Sundler F (1986) Peptidergic innervation in infantile hypertrophic pyloric stenosis. J Pediatr Surg 21(4):303–306

    CAS  PubMed  Google Scholar 

  63. Mercado-Deane MG, Burton EM et al (1994) Prostaglandin-induced foveolar hyperplasia simulating pyloric stenosis in an infant with cyanotic heart disease. Pediatr Radiol 24(1):45–46

    CAS  PubMed  Google Scholar 

  64. Mitchell LE, Risch N (1993) The genetics of infantile hypertrophic pyloric stenosis. A reanalysis. Am J Dis Child 147(11):1203–1211

    CAS  PubMed  Google Scholar 

  65. Miyazaki E, Yamataka T et al (1998) Active collagen synthesis in infantile hypertrophic pyloric stenosis. Pediatr Surg Int 13(4):237–239

    CAS  PubMed  Google Scholar 

  66. Moazam F, Rodgers BM et al (1978) Fasting and postprandial serum gastrin levels in infants with congenital hypertrophic pyloric stenosis. Ann Surg 188(5):623–625

    CAS  PubMed  Google Scholar 

  67. Ng E, Shah VS (2008) Erythromycin for the prevention and treatment of feeding intolerance in preterm infants. Cochrane Database Syst Rev(3): CD001815

  68. Nielsen JP, Haahr P et al (2000) Infantile hypertrophic pyloric stenosis. Decreasing incidence. Dan Med Bull 47(3):223–225

    CAS  PubMed  Google Scholar 

  69. Nielsen OS (1956) Histological changes of the pyloric myenteric plexus in infantile pyloric stenosis; studies on surgical biopsy specimens. Acta Paediatr 45(6):636–647

    CAS  PubMed  Google Scholar 

  70. O’Neill JA, Rowe MI et al (1998) Pediatric surgery. Mosby, St Louis

    Google Scholar 

  71. Ohshiro K, Puri P (1998) Increased insulin-like growth factor-I mRNA expression in pyloric muscle in infantile hypertrophic pyloric stenosis. Pediatr Surg Int 13(4):253–255

    CAS  PubMed  Google Scholar 

  72. Ohshiro K, Puri P (1998) Increased insulin-like growth factor and platelet-derived growth factor system in the pyloric muscle in infantile hypertrophic pyloric stenosis. J Pediatr Surg 33(2):378–381

    CAS  PubMed  Google Scholar 

  73. Ohshiro K, Puri P (1998) Pathogenesis of infantile hypertrophic pyloric stenosis: recent progress. Pediatr Surg Int 13(4):243–252

    CAS  PubMed  Google Scholar 

  74. Okazaki T, Yamataka A et al (1994) Abnormal distribution of nerve terminals in infantile hypertrophic pyloric stenosis. J Pediatr Surg 29(5):655–658

    CAS  PubMed  Google Scholar 

  75. Okazaki T, Yamataka A et al (1994) Abnormal distribution of synaptic vesicle proteins in infantile hypertrophic pyloric stenosis. J Pediatr Gastroenterol Nutr 18(2):254–255

    CAS  PubMed  Google Scholar 

  76. Oue T, Puri P (1999) Abnormalities of elastin and elastic fibers in infantile hypertrophic pyloric stenosis. Pediatr Surg Int 15(8):540–542

    CAS  PubMed  Google Scholar 

  77. Panteli C, Filippopoulos A et al (2008) Infantile pyloric stenosis: Interstitial cells of Cajal, nitric oxide or both? 9th EUPSA Congress. Istanbul, Turkey

    Google Scholar 

  78. Paulozzi LJ (2000) Is Helicobacter pylori a cause of infantile hypertrophic pyloric stenosis? Med Hypotheses 55(2):119–125

    CAS  PubMed  Google Scholar 

  79. Persson S, Ekbom A et al (2001) Parallel incidences of sudden infant death syndrome and infantile hypertrophic pyloric stenosis: a common cause? Pediatrics 108(4):E70

    CAS  PubMed  Google Scholar 

  80. Piotrowska AP, Solari V et al (2003) Distribution of heme oxygenase-2 in nerves and interstitial cells of Cajal in the normal pylorus and in infantile hypertrophic pyloric stenosis. Arch Pathol Lab Med 127(9):1182–1186

    PubMed  Google Scholar 

  81. Pisacane A, de Luca U et al (1996) Breast feeding and hypertrophic pyloric stenosis: population based case-control study. BMJ 312(7033):745–746

    CAS  PubMed  Google Scholar 

  82. Porcher C, Orsoni P et al (1999) Distribution of heme oxygenase 2 in nerves and c-kit(+) interstitial cells in human stomach. Histochem Cell Biol 112(4):317–322

    CAS  PubMed  Google Scholar 

  83. Publicover NG, Hammond EM et al (1993) Amplification of nitric oxide signaling by interstitial cells isolated from canine colon. Proc Natl Acad Sci USA 90:2087–2091

    CAS  PubMed  Google Scholar 

  84. Rintoul JR, Kirkman NF (1961) The myenteric plexus in infantile hypertrophic pyloric stenosis. Arch Dis Child 36:474–480

    CAS  PubMed  Google Scholar 

  85. Rogers IM (2006) The true cause of pyloric stenosis is hyperacidity. Acta Paediatr 95:132–136

    PubMed  Google Scholar 

  86. Rogers IM, Drainer IK et al (1979) Serum cholecystokinin, basal acid secretion, and infantile pyloric stenosis. Arch Dis Child 54(10):773–775

    CAS  PubMed  Google Scholar 

  87. Rogers IM, Drainer IK et al (1975) Plasma gastrin in congenitial hypertrophic pyloric stenosis. A hypothesis disproved. Arch Dis Child 50(6):467–471

    CAS  PubMed  Google Scholar 

  88. Rogers IM, Macgillion F et al (1976) Congenital hypertrophic pyloric stenosis: a gastrin hypothesis pursued. J Pediatr Surg 11(2):173–176

    CAS  PubMed  Google Scholar 

  89. Romeo C, Santoro G et al (2007) Sarcoglycan immunoreactivity is lacking in infantile hypertrophic pyloric stenosis. A confocal laser scanning microscopic study. Pediatr Med Chir 29(1):32–37

    CAS  PubMed  Google Scholar 

  90. Saps M, Di Lorenzo C (2008) Gastric motility. In: Kleinman R, Goulet OG, Mieli-Vergani G, Sanderson I (eds) Walker’s Pediatric gastrointestinal disease, vol 1. McGraw-Hill, New York, pp 187–193

    Google Scholar 

  91. Saur D, Vanderwinden JM et al (2004) Single-nucleotide promoter polymorphism alters transcription of neuronal nitric oxide synthase exon 1c in infantile hypertrophic pyloric stenosis. Proc Natl Acad Sci USA 101(6):1662–1667

    CAS  PubMed  Google Scholar 

  92. Shen Z, She Y et al (1990) Immunohistochemical study of peptidergic nerves in infantile hypertrophic pyloric stenosis. Pediatr Surg Int 5:110–113

    Google Scholar 

  93. Sherwood W, Choudhry M et al (2007) Infantile hypertrophic pyloric stenosis: an infectious cause? Pediatr Surg Int 23(1):61–63

    CAS  PubMed  Google Scholar 

  94. Shima H, Ohshiro K et al (2000) Increased local synthesis of epidermal growth factors in infantile hypertrophic pyloric stenosis. Pediatr Res 47(2):201–207

    CAS  PubMed  Google Scholar 

  95. Shima H, Puri P (1999) Increased expression of transforming growth factor-alpha in infantile hypertrophic pyloric stenosis. Pediatr Surg Int 15(3–4):198–200

    CAS  PubMed  Google Scholar 

  96. Shinohara K, Shimizu T et al (1998) Correlation of prostaglandin E2 production and gastric acid secretion in infants with hypertrophic pyloric stenosis. J Pediatr Surg 33(10):1483–1485

    CAS  PubMed  Google Scholar 

  97. Snyder JD, Rosenblum N et al (1987) Pyloric stenosis and eosinophilic gastroenteritis in infants. J Pediatr Gastroenterol Nutr 6(4):543–547

    Article  CAS  PubMed  Google Scholar 

  98. Sommerfield T, Chalmers J et al (2008) The changing epidemiology of infantile hypertrophic pyloric stenosis in Scotland. Arch Dis Child 93(12):1007–1011

    CAS  PubMed  Google Scholar 

  99. Sorensen HT, Norgard B et al (2002) Maternal smoking and risk of hypertrophic infantile pyloric stenosis: 10 year population based cohort study. BMJ 325(7371):1011–1012

    PubMed  Google Scholar 

  100. Sorensen HT, Skriver MV et al (2003) Risk of infantile hypertrophic pyloric stenosis after maternal postnatal use of macrolides. Scand J Infect Dis 35(2):104–106

    CAS  PubMed  Google Scholar 

  101. Spitz L, Kaufmann JC (1975) The neuropathological changes in congenital hypertrophic pyloric stenosis. S Afr J Surg 13(4):239–242

    CAS  PubMed  Google Scholar 

  102. Spitz L, Zail SS (1976) Serum gastrin levels in congenital hypertrophic pyloric stenosis. J Pediatr Surg 11(1):33–35

    CAS  PubMed  Google Scholar 

  103. Stromer MH (1995) Immunocytochemistry of the muscle cell cytoskeleton. Microsc Res Tech 31(2):95–105

    CAS  PubMed  Google Scholar 

  104. Subramaniam R, Doig CM et al (2001) Nitric oxide synthase is absent in only a subset of cases of pyloric stenosis. J Pediatr Surg 36:616–619

    CAS  PubMed  Google Scholar 

  105. Svenningsson A, Lagerstedt K et al (2008) Absence of motilin gene mutations in infantile hypertrophic pyloric stenosis. J Pediatr Surg 43(3):443–446

    PubMed  Google Scholar 

  106. Tam PK (1986) An immunochemical study with neuron-specific-enolase and substance P of human enteric innervation—the normal developmental pattern and abnormal deviations in Hirschsprung’s disease and pyloric stenosis. J Pediatr Surg 21(3):227–232

    CAS  PubMed  Google Scholar 

  107. Vanderwinden JM, Liu H et al (1996) Study of the interstitial cells of Cajal in infantile hypertrophic pyloric stenosis. Gastroenterology 111(2):279–288

    CAS  PubMed  Google Scholar 

  108. Vanderwinden JM, Mailleux P et al (1992) Nitric oxide synthase activity in infantile hypertrophic pyloric stenosis. N Engl J Med 327(8):511–515

    Article  CAS  PubMed  Google Scholar 

  109. Ward SM (2000) Interstitial cells of Cajal in enteric neurotransmission. Gut 47:iv40–iv43

    PubMed  Google Scholar 

  110. Wattchow DA, Cass DT et al (1987) Abnormalities of peptide-containing nerve fibers in infantile hypertrophic pyloric stenosis. Gastroenterology 92(2):443–448

    CAS  PubMed  Google Scholar 

  111. Wiley JW (2007) The many faces of nitric oxide: cytotoxic, cytoprotective or both. Neurogastroenterol Motil 19:541–544

    CAS  PubMed  Google Scholar 

  112. Yamataka A, Fujiwara T et al (1996) Lack of intestinal pacemaker (C-KIT-positive) cells in infantile hypertrophic pyloric stenosis. J Pediatr Surg 31(1):96–98 discussion 98-9

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Christina Panteli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Panteli, C. New insights into the pathogenesis of infantile pyloric stenosis. Pediatr Surg Int 25, 1043–1052 (2009). https://doi.org/10.1007/s00383-009-2484-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-009-2484-x

Keywords

Navigation