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复发性幽门狭窄:扩张还是手术?初步报告。

Recurrent pyloric stenosis: to dilate or operate? A preliminary report.

作者信息

Nasr Ahmed, Ein Sigmund H, Connolly Bairbre

机构信息

The Division of General Surgery and The Department of Interventional Radiology, The Hospital for Sick Children, Toronto, Ontario, Canada, M5G 1X8.

出版信息

J Pediatr Surg. 2008 Feb;43(2):e17-20. doi: 10.1016/j.jpedsurg.2007.10.039.

DOI:10.1016/j.jpedsurg.2007.10.039
PMID:18280264
Abstract

PURPOSE

Idiopathic hypertrophic pyloric stenosis is a common surgical problem in infants, and pyloromyotomy is almost always successful in alleviating the obstruction. There are few reports in the literature that discuss recurrent pyloric stenosis as opposed to incomplete pyloromyotomy. We report 2 such babies with different cures.

METHODS

The health records department files were electronically searched for the number of infants at our children's hospital with hypertrophic pyloric stenosis seen over the past 30 years (1973-2003), and the recurrences were reviewed.

RESULTS

Recurrent pyloric stenosis was encountered in 2 cases (<0.07%). Balloon dilatation was first tried in both cases and was successful in 1 case; redo pyloromyotomy was required for the second case.

CONCLUSION

Recurrent pyloric stenosis is rare. Fluoroscopic balloon dilatation of the pylorus warrants further study as the first choice for curing this problem, and if unsuccessful, redo pyloromyotomy.

摘要

目的

特发性肥厚性幽门狭窄是婴儿常见的外科问题,幽门肌切开术几乎总能成功缓解梗阻。与不完全幽门肌切开术不同,文献中很少有关于复发性幽门狭窄的报道。我们报告2例采用不同治疗方法的此类婴儿。

方法

通过电子检索我院健康记录部门档案,统计过去30年(1973 - 2003年)在我院就诊的肥厚性幽门狭窄婴儿数量,并对复发情况进行回顾。

结果

2例(<0.07%)出现复发性幽门狭窄。2例均首先尝试球囊扩张,其中1例成功;第2例需要再次进行幽门肌切开术。

结论

复发性幽门狭窄罕见。透视下幽门球囊扩张作为解决该问题的首选方法值得进一步研究,若不成功,则需再次进行幽门肌切开术。

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Recurrent pyloric stenosis: to dilate or operate? A preliminary report.复发性幽门狭窄:扩张还是手术?初步报告。
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Update on endoscopic management of gastric outlet obstruction in children.儿童胃出口梗阻的内镜治疗进展
World J Gastrointest Endosc. 2016 Oct 16;8(18):635-645. doi: 10.4253/wjge.v8.i18.635.
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The ins and outs of pyloromyotomy: what we have learned in 35 years.幽门肌切开术的来龙去脉:我们35年所学到的东西。
Pediatr Surg Int. 2014 May;30(5):467-80. doi: 10.1007/s00383-014-3488-8. Epub 2014 Mar 14.
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Insights Imaging. 2012 Jun;3(3):247-50. doi: 10.1007/s13244-012-0168-x. Epub 2012 May 1.
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Management of pyloric stricture in children: endoscopic balloon dilatation and surgery.儿童幽门狭窄的治疗:内镜球囊扩张与手术。
Surg Endosc. 2012 Jul;26(7):1903-8. doi: 10.1007/s00464-011-2124-0. Epub 2012 Jan 11.