Narrowing of the muscular outlet of the stomach (pylorus). This causes delay in passage of the stomach contents to the duodenum, which leads to repeated vomiting (sometimes of food eaten more than 24 hours earlier), and sometimes visible distension and movement of the stomach. If the condition persists the patient loses weight, becomes dehydrated, and develops alkalosis. Congenital hypertrophic pyloric stenosis occurs in babies about 3–5 weeks old (particularly boys) in which the thickened pyloric muscle can be felt as a nodule. Treatment is by the surgical operation of pyloromyotomy (Ramstedt’s operation). Recovery is usually complete and the condition does not recur. Pyloric stenosis in adults is caused either by a peptic ulcer close to the pylorus or by a cancerous growth invading the pylorus. Stenosis from peptic ulceration may be treated by healing the ulcer with an antisecretory drug and dilating the pylorus with a balloon, or by surgical removal or bypass (see gastroenterostomy). Surgery is usually required for cancerous obstruction, although in unfit patients a stent can be placed to relieve the obstruction.
Subjects: Medicine and Health.