Stenosis of the pylorus of the stomach and esophagus

Definition of stenosis of the pylorus of the stomach

Stenosis of the pylorus of the stomach (pyloric stenosis) is a complication of gastric ulcer in which there is a narrowing of the lumen in this region of the digestive tract and breaks down the passage of food into the intestine from the stomach. Over time, this pathology leads to the development of serious disorders in the body and alteration of homeostasis. Such stenosis occurs in adults and is only acquired.

The causes of stenosis of the pylorus of the stomach

One of the reasons for development of stenosis of the stomach is the rumen, consisting of connective tissue and formed in the healing process of peptic ulcer disease. It tightens the stomach wall, making it inactive.

Another reason for the development of stenosis can be vnutrismennyh cancer. The tumor grows into the fabric, resulting in narrowing of the lumen of the gastrointestinal tract. Food moving through the digestive tract, can not fully get into the intestines. It is stagnation. To evacuate contents from the stomach starts to grow the muscle sheath. This in some measure kompensiruet stenosis.

However, with time and hypertrophied muscle layer of the stomach cannot cope with the load, and an increase in the contents of the stomach leads to distension. As a result of stagnation, the food under the influence of microbes begins to decompose and ferment.

In disease there are the following stages:

1. The first phase – compensated pyloric stenosis. The hole narrowed slightly. The patient complaints of belching with a sour taste, feeling of a full stomach after a meal. Occasionally there is vomiting, which brings relief for a short time. The patient's condition, in General, satisfactory.

2. The second stage – the stage of subcompensation. The patient is already constant feeling crowded stomach, which is associated with belching and pain. Vomiting occurs some time later or immediately after a meal, brings relief. Over time, the person loses weight. When inspection and palpation of the abdomen is heard splashing in the navel.

3. The third stage – the stage of decompensation. After a time the disease progresses, the stomach is distended. Condition significantly deteriorates, develops exhaustion, dehydration. Vomiting is often does not bring relief. Vomit in large quantity, malodorous, have in large quantitythe remains of a multi-day food.

Diagnosis and treatment of stenosis of the pylorus of the stomach

The disease diagnosis is based on the following studies:

· X-ray examination. In this case, may be increasing the size of the stomach, reducing peristaltic activity, narrowing the channel, increasing the time of evacuation of stomach contents;

· Esophagogastroduodenoscopy. It shows the narrowing and deformity of the stomach in the opening, the expansion of the stomach;

· Study of the motor functions (using the method of electrogastroenterography). This method gives the opportunity to learn about tone, electrical activity, frequency and amplitude of the contractions of the stomach after a meal and on an empty stomach;

· Ultrasound. In the later stages allows you to visualize the enlarged stomach.

Treatment of stenosis of the pylorus of the stomach (pyloric stenosis) surgery only. Drug therapy includes treatment of the underlying disease, preoperative preparation. Assigned antiulcer drugs, carry out the correction of disorders of protein, water and electrolyte metabolism, recovery of body weight.

Prevention includes timely treatment of peptic ulcer disease.

Congenital stenosis of the pylorus of the stomach

Children can meet pyloric stenosis congenital in nature. Often the disease is hereditary. Stenosis is a growth of connective tissue in the area of the output section of the stomach. This is the most common cause of gastric obstruction in infants, and the boys suffer four times more often than girls.

The disease appears on the second to fourth week of life. The main symptom frequent and severe vomiting "fountain" in the time after feeding. Treatment only operative. Prognosis after surgery is favourable, subject to timely begun treatment.

Stenosis of the esophagus

In congenital stenosis of the esophagus cause is fetal malformation. The disease manifests itself right from the first days of life when feeding baby. The child immediately begins to spit up milk. If the stenosis is expressed slightly, the symptoms appear when the introduction of solid food.

With acquired stenosis of the esophagus also narrows its lumen. Causes leading to disruption of normal patency of the esophagus, a few:

· Scarring as a result of inflammatory, infectious diseases, transferredpeptic gastric ulcers, gastroesophageal reflux disease;

· Trauma, burns of the esophagus;

· Tumors of the esophagus and surrounding tissue;

· Aortic aneurysm, enlarged lymph nodes, abnormal location of blood vessels.

The main symptoms of stenosis are: pain when eating, in the course of the esophagus, excessive salivation, belching, and sometimes vomiting, bleeding. Stenosis of the esophagus following degrees:

1. The first degree is characterized by recurrent violation of swallowing of solid food.

2. Second degree is characterized by the passage through the esophagus only semi-liquid food.

3. Third degree – is only liquid food.

4. The fourth degree of stenosis with difficulty swallow water and saliva.

The diagnosis is esophagoscopy, an x-ray with barium suspension. Treatment depends on the cause and severity of the disease and will be operational or conservative. The conservative treatment is the correction of nutrition disorders, therapy, the probing of the esophagus. When the surgical treatment is carried out for the plastic surgery of esophagus, dissection scars, superimposed gastrostomy.