ISSN 2398-2969      

Stomach: pyloric stenosis

icanis

Introduction

  • Congenital or acquired hypertrophy of circular muscle fibers or hyperplasia of pyloric mucosa (or both) of pyloric ring of stomach.
  • Cause: may be associated with excess gastrin levels or abnormal neuro-muscular control.
  • Signs: vomiting food at variable interval following feeding.
  • Diagnosis: no definitive test - suspect on clinical and contrast radiographic examination + gastroscopy.
  • Treatment: pyloroplasty or pyloromyotomy.
  • Prognosis: good.

Pathogenesis

Etiology

  • Excessive gastrin levels causing hypertrophy of circular muscle fibers (congenital form).
  • Possible neuro-muscular dysfunction.
  • Acquired = mucosal hypertrophy.

Pathophysiology

  • Neuromuscular dysfunction → motility disorder → failure of pylorus to open.
  • Obstruction to gastric outflow → gastric distension → gastrin release → hypertrophy of muscle fibers and mucosal hyperplasia.
  • Failure of pyloric ring to relax → vomiting of stomach contents.

Timecourse

  • Weeks to months.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Matthiesen D T, Walter M C (1985) Surgical treatment of chronic hypertrophic pyloric gastropathy in 45 dogs. JAAHA 22 (2), 241-247 VetMedResource.

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