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Pavlov A., Zolnikov Z., Morozov R.
Diagnosis and treatment of children with congenital hypertrophic pyloristenosis in the Chuvash Republic
Keywords: pyloristenosis, diagnosis of pyloristenosis, pyloristenosis treatment, endovideosurgery, retrospective analysis
Currently there are some unsolved issues associated with congenital hypertrophic pyloristenosis (CHPS): what is the cause of it? Are there any genetic defects in these children and how to diagnose and treat CHPS? The authors of the article conducted retrospective analysis of diagnostic techniques and methods of operative treatment of 50 children diagnosed with CHPS and admitted to the Republican children's clinical hospital (RCHCH) of Cheboksary from 2009 to 2014. All children underwent ultrasonography (USG) of the pyloric part of the stomach (PPS), if sonographic signs caused doubts, fiberoptic esophagogastroduodenoscopy (FEGDS) was performed. Ultrasound examination in children with CHPS noted PPS elongation up to 20,88±1,2 mm, increase in muscular layer diameter and thickness up to 13,57±2,24 mm and 4,91±1,08 mm, pyloric channel narrowing up to 1,87±0,73 mm, compared with the control children. FEGDS determined increase in antral folds’ volume, overlap of the entrance to pylorus with rigid folds, lumen narrowing which did not disclose in air insufflation, resistance when trying to get to the duodenal bulb and lack of motility in response to external stimuli. All children underwent surgery and were divided into two groups: the treatment group consisted of children who underwent endovideosurgical pyloromyotomy (EVP) and the control group patients, who had classic right supraumbilical Fredet-Ramshtedt pyloromyotomy (CP) performed. In all children postoperative wounds healed per primam without complications. Treatment group children began to receive oral feeding on the second day and the children from the control group began to be fed on the fourth day after surgery. Treatment group children stayed at the hospital l8,00±4,56 bed days after surgery, which was less than in the control group, where bed-days after surgery made up 12,44±3,47.
References
- Akzhigitov G.N., Petrenyuk V.S., Naiman E.L., Listopad G.G. O semeinom kharaktere vrozhdennogo pilorostenoza [About the family nature of congenital pyloric stenosis]. Zhurnal im. G.N. Speranskogo [Pediatriya. Journal named after G.N. Speransky], 1989, no. 3, p. 90.
- Ashkraft K.U., Kholder T.M. Detskaya khirurgiya [Pediatric surgery]. St. Petersburg, Khardford Publ., 1996, vol.1, 384 p.
- Bushmelev V.A., Abramova N.E. Opyt diagnostiki i lecheniya vrozhdennogo pilorostenoza [Experience in diagnosis and treatment of congenital pyloric stenosis]. Zhurnal im. G.N. Speranskogo [Pediatriya. Journal named after G.N. Speransky], 1988, no. 3, pp. 60–64.
- Vorontsov Yu.P., Mostovaya S.S., Nadiradze T.B., Masenkov Yu.I. Fibroga-stroskopiya v diagnostike gipertroficheskogo pilorostenoza u detei [Fibrogastroscopy in the diagnosis of hypertrophic pyloric stenosis in children]. Pediatriya [Pediatrics],1986, no. 3, pp. 47–48.
- Gumerov A.A., Sataev V.U., Mamleev I.A., Khasanov R.Sh., Makushkin V.V., Alyangin V.G. Endoskopicheskie aspekty diagnostiki vrozhdennogo pilorostenoza i opyt pervykh laparaskopicheskikh piloromiotomii [Endoscopic aspects in diagnosis of congenital pyloric stenosis and the first experience of laparoscopic pyloromyotomy]. Detskaya khirurgiya [Pediatric surgery], 1997, no. 2, pp. 33–35.
- Isakov Yu.F., Stepanov E.A., Krasovskaya T.V. Abdominal’naya khirurgiya u detei [Abdominal surgery in children]. Moscow, Meditsina Publ., 1988, 416 p.
- Kashin M.B., Kirkizh V.S., Daminov F.R. Redkii sluchai semeinogo pilorostenoza [A rare case of pyloric stenosis family]. Zhurnal im. G.N. Speranskogo [Pediatriya. Journal named after G.N. Speransky], 1988, no. 3, p. 91.
- Kozlov Yu.A., Novozhilov V.A., Kuznetsova S.N., Aleinikova N.G., Veber I.N., Kovalev V.M., Makhov A.N. Umbilikal’nyi dostup pri piloromiotomii Ramshtedta [Umbilical access pyloromyotomy of Ramstedt]. Detskaya khirurgiya [Pediatric surgery], 2007, no. 5, pp. 28–29.
- Martynenko V.N., Minaev S.V., Vereyutin Yu.M., Bykov N.I., Timofeev S.I. Ul’trasonografiya vrozhdennogo pilorostenoza [Ultrasonography of congenital pyloric stenosis]. Detskaya khirurgiya [Pediatric surgery], 2003, no.2, pp. 18–21.
About authors
- Pavlov Anatoly Aleksandrovich
- candidate of medical sciences, pediatrics and pediatric surgery department associate professor, Chuvash State University, Russia, Cheboksary (rdkb@med.cap.ru; )
- Zolnikov Zot Ivanovich
- candidate of medical sciences, pediatrics and pediatric surgery department associate professor, Chuvash State University, Russia, Cheboksary (rdkb@med.cap.ru; )
- Morozov Ruslan Vladimirovich
- medical faculty 5th year student, Chuvash State University, Russia, Cheboksary (dr.MorozovRV@yandex.ru; )
Article link
Pavlov A., Zolnikov Z., Morozov R. Diagnosis and treatment of children with congenital hypertrophic pyloristenosis in the Chuvash Republic [Electronic resource] // Acta medica Eurasica. – 2016. – №4. P. 7-13. – URL: https://acta-medica-eurasica.ru/en/single/2016/4/2/.