Radiology and pathological observations of a series of seventeen cases of hypertrophic pyloric stenosis of adults (abstract only)

ABSTRACT

Hypertrophic pyloric stenosis of the adult is a well recognised radiological and pathological entity, with characteristic radiological appearance and typical pathological changes due to hypertrophy and hyperplasia of the circular muscle of the pyloric sphincter and adjacent part of the pyloric antrum. A study of seventeen cases with radiological investigation and surgical treatment at the University Hospital of the West Indies was undertaken. Only six of these cases had the classical radiological appearance of a narrowed and elongated pyloric canal. Six cases showed minimal narrowing but marked irregularity of the pylorid antrum and canal, the appearance usually described as antral gastritis. Four cases presented as pyloric stenosis. The radiographs were not available in the seventeenth case. There was a high incidence of lesser curve gastric ulcer and the significance of this is discussed. The macroscopic appearances were typical of this condition. The use of a special staining technique demonstrated that in addition to muscle hypertrophy, there was also much fibrosis between the muscle bundles. This suggests that the condition may arise from a prepyloric ulcer and evidence is presented in support of this. (AU)