Endoscopic submucosal dissection (ESD) has been widely accepted as a curative treatment for gastric neoplasm. Pyloric stenosis is a chronic complication that can be caused by ESD. The aim of this study is to clarify the risk factors and management for pyloric stenosis. From January 2004 to January 2014, a total of 126 patients who underwent ESD adjacent to pylorus were reviewed retrospectively. Pyloric mucosal defect was defined as when any resection margin of ESD was involved in the pyloric ring. Pyloric stenosis was defined as when a conventional endoscope could not be passed to the duodenum. Among the 126 patients, pyloric stenosis was identified in 9. In a univariate analysis, pyloric stenosis was more common in older patients (P < 0.05) and in lesions with resections over 75% of the pyloric ring circumference (P < 0.001). In a multivariate analysis, the factor that was associated with pyloric stenosis was the extent of the pyloric ring dissection (P < 0.001). Four of the 9 patients with pyloric stenosis had mild dyspepsia, and the others had gastric outlet obstruction symptoms. The 5 symptomatic patients underwent endoscopic balloon dilation (EBD), and the frequency of EBD was 1 to 8 times. The asymptomatic patients were treated conservatively. The incidence of pyloric stenosis was higher in lesions with resections over 75% of the pyloric ring circumference. Although EBD was an effective treatment for pyloric stenosis, conservative management was also helpful in patients who had mild symptoms.
Aim: To mine and analyze adverse drug events (ADEs) signals of azithromycin use in children in the real world to inform the safety assessment of azithromycin use in children.
Methods: ADE reports from the FDA Adverse Event Reporting System (FAERS) involving children (0-17 years) with azithromycin as the primary suspected drug from 2004 to early 2024 were extracted. ADEs were categorized using MedDRA, and signal detection was conducted using Reporting Odds Ratio (ROR) and Proportional Reporting Ratio (PRR).
Congenital colonic stenosis (CCS) is a rare cause of intestinal obstruction, most commonly presenting in the neonatal period. We present a case of delayed CCS and describe the diagnostic challenges experienced. A 16-week-old female patient presented with persistent failure to thrive associated with signs of intestinal obstruction.
A 60s male patient diagnosed with advanced gastric cancer (with pyloric stenosis and enlarged lymph nodes) experienced significant tumor reduction after two courses of chemotherapy before surgery.
He underwent laparoscopic gastric jejunal bypass followed by distal gastrectomy and para-aortic lymph node dissection, with positive surgical results and no further tumor growth observed.
After the operation, he received a year of adjuvant chemotherapy and has remained recurrence-free for 1.5 years, highlighting the effectiveness of preoperative treatment for this condition.
Department of Pediatric Surgery, Bab Al Hawa Hospital, Edlib, Syria; Department of Pediatric Surgery, DEVA Hospital, Aleppo, Syria; Scientific Committee of Pediatric Surgery in Syrian Board of Medical Specialities (SBOMS), Syria. Electronic address:
Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC, Amsterdam Reproduction and Development Research Institute, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.
The study aimed to assess the long-term gastrointestinal effects of pyloromyotomy in children who had undergone this surgery for infantile hypertrophic pyloric stenosis (IHPS) from 2007 to 2017.
A questionnaire, including the Pediatric Quality of Life Inventory™ Gastrointestinal symptoms module, was completed by 199 participants, revealing that their GI symptoms scores were similar to those of healthy peers.
The results suggest that long-term GI issues after pyloromyotomy are rare, indicating no significant difference in health outcomes between these children and healthy controls, which can help inform parents and lessen the need for extensive follow-up care.
