Stomach: chronic hypertrophic gastritis

Antral pyloric hypertrophy • Hypertrophic pyloric gastropathy HPG

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Introduction

  • Uncommon.
  • Cause : possibly excessive hormonal trophic factors, eg gastrin → focal, localized, eg pylorus obstruction or diffuse thickening of gastric mucosa. Reaction to foreign body, gastrinoma.
  • Signs : vomiting of variable character with or without blood.
  • Diagnosis : gastroscopy and histopathology; laparotomy and histopathology. Often normal biopsies with endoscopy. Laprotomy to get submucosa/muscle in biopsy.
  • Treatment : treat underlying cause or symptomatic.
  • Prognosis : depends on finding and eliminating the underlying cause.

Outcomes

Prognosis

  • Variable depending on severity and area affected, ie may require pyloroplasty .
  • If associated with familial intestinal disease and renal tubular defect (Basenji), systemic mast cell neoplasia, or gastroma - poor prognosis.

Expected response to treatment

  • Control of vomiting with medical and dietary management.

Reasons for treatment failure

  • Failure to treat underlying disease.
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