Neuromuscular Blocking Agents and Rapid Sequence Induction for Laparoscopic Pyloromyotomy: Impact on Time to Extubation and Perioperative Complications
Conclusion The use of succinylcholine, cisatracurium, or no NMBA at induction of anesthesia in infants undergoing laparoscopic pyloromyotomy had no statistically significant effect on time until extubation and complication rates. A modified RSI seems to be safe and effective in these cases. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Abstract | Full text
I would like to thank the authors of the article - Optimizing fluid resuscitation in hypertrophic pyloric stenosis (PS)  for highlighting an important point in the pre-operative preparation of these neonates. Their comments arise from a large experience. Some of these abnormalities can lead to an appropriate but significant and necessary delay in surgical treatment. Conventionally, preoperative intra-venous fluid is given to allow the neonatal kidneys to correct the alkalosis, dehydration, and electrolyte abnormalities.
This study lists the various anomalies on the basis of 504 references selected from a PubMed search in October 2018. RESULTS: The anomalies are grouped into three categories: anatomical anomalies: duodenal atresia and stenosis (3.9%), duodenal web and annular pancreas; aberrant right subclavian artery (12% of children with DS with cardiac anomaly); Hirschsprung's disease (2.76%); anorectal malformation (1.16%); congenital vascular malformations of the liver; orofacial cleft, bifid uvula (4.63%), and submucous orofacial cleft; esophageal atresia (0.5-0.9%); pyloric stenosis (0.3%); diaphragmatic hernia; malrotation of ...
In conclusion, these findings indicate that CGL4 patients should also be carefully followed up for gastrointestinal and cardiac manifestations. PMID: 31778856 [PubMed - as supplied by publisher]
European J Pediatr Surg Rep 2019; 07: e66-e68 DOI: 10.1055/s-0039-1698400A male infant aged 45 days presented with projectile nonbilious vomiting for 2 weeks. Ultrasound showed picture of idiopathic hypertrophic pyloric stenosis. Laparoscopic pyloromyotomy was done, but postoperative vomiting that was mainly nonbilious continued without improvement. After 4 days of persistent vomiting, laparoscopic exploration was done and complete pyloromyotomy was confirmed and malrotation with complete Ladd's band was found, then case converted to open laparotomy and Ladd's procedure was done. Postoperatively, vomiting stopped completel...
AbstractPurposeTo retrospectively review imaging planes, number of visible pyloric layers and location of measurements, in infants with suspected (HPS).Methods103 pyloric ultrasound studies for suspected HPS were included. For each study, we recorded whether longitudinal or transverse views were performed, the layers visualized (a schematic was developed for two pediatric radiologists to categorize the interfaces of the anatomic layers a –e) and position of the internal measurement cursor. Categories for the anterior (superficial wall) layers were from external to internal: (a) internal aspect of the muscularis propr...
The purpose of this analysis was to determine if a correlation exists between socioeconomic status (SES) and pyloric stenosis (PS) as well as between PS and feeding method.
ConclusionSymptoms of pyloric obstruction as a manifestation of isolated gastric Crohn ’s disease are extremely unusual in clinical practice, awareness of which would facilitate early appropriate investigations and treatment.
The real pathogenesis of Pyloric Stenosis of Infancy (PS) is becoming clearer:  Inherited hyperacidity starts the process,  Acid stimulated sphincter contraction follows, [3-5] Repeated contraction by attracting growth factors locally causes sphincter hypertrophy, especially marked in the trophic ambience of the temporarily hypergastrinaemic baby  . It can be no coincidence that peak acidity occurs in all normal babies at around 3 –4 weeks of age, the classical time that symptoms develop .
Conditions: Infantile Hypertrophic Pyloric Stenosis; Pyloromyotomy Intervention: Procedure: G-POEM Sponsor: Shanghai Zhongshan Hospital Recruiting