成人の肥厚性幽門狭窄症の1例

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  • A CASE OF ADULT HYPERTROPHIC PYLORIC STENOSIS

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A 57-year-old man who had suffered cerebral infarction for about one year was admitted to Itoigawa hospital in Niigata because of frequent vomiting.<br> Radiographically, the pylorus of the patient showed string sign, and endoscopic examination revealed pyloric stenosis representing a uterine cervix-like appearance of unknown genesis. Endoscopic dilatation of the pylorus was successfully performed.<br> But one month after the treatment, recurrence of the symptoms was recognized, followed by retreatment by using endoscopy, resulting in no marked improvement of symptoms.<br> Because of the failure of the endoscopic treatment, the patient underwent pyloroplasty of the Heinecke-Mikulica type when the pylorus showed extramural hypertrophic protrusion.<br> Histologic examination of the resected specimen showed hypertrophy of pyloric circular smooth muscles.<br> A diagnosis of adult hypertrophic pyloric stenosis was made on the basis of the radiographic, endoscopic and histologic findings described above.<br> Postoperative roentgenographic examination disclosed no passage disturbance of the pylorus.<br> The patient has been well for about a year postoperatively without serious symptoms from this particular disorder.

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