Congenital Gastric Outlet Obstruction (Pyloric and Antral Atresia and Web)



Fig. 19.1
Diagrammatic representation of antral membrane (a) and antral membrane forming a windsock (b)







  • Rarely, there is an antral atresia with a gap (Fig. 19.2).



    A321246_1_En_19_Fig2_HTML.jpg


    Fig. 19.2
    Diagrammatic representation of antral gap atresia


  • Pyloric atresia is divided into three types:





    • Type 1: Pyloric atresia with a membrane (Fig. 19.3a)



      A321246_1_En_19_Fig3_HTML.jpg


      Fig. 19.3
      a and b Diagrammatic representation of types 1and 2 pyloric atresia


    • Type 2: Pyloric atresia with a solid cord between the two ends (Fig. 19.3b)


    • Type 3: Pyloric atresia with a gap between the stomach and duodenum (Fig. 19.4)



      A321246_1_En_19_Fig4_HTML.jpg


      Fig. 19.4
      Diagrammatic representation of type 3 pyloric atresia


  • Type 1 is the commonest.






      Associated Anomalies






      • Epidermolysisbullosa (Fig. 19.5; the association of CPA with EB should not preclude surgical treatment).



        A321246_1_En_19_Fig5_HTML.jpg


        Fig. 19.5
        a and b Clinical photograph showing aplasia cutis congenita and epidermolysisbullosa in a patient with congenital pyloric atresia


      • ACC.


      • Hereditary multiple intestinal atresia (HMIA) .


      • CPA in association with HMIA is universally fatal as so far none of the reported cases survived.


      • Recently, a combined immunodeficiency syndrome was reported in patients with HMIA.

    • Mar 8, 2017 | Posted by in PEDIATRICS | Comments Off on Congenital Gastric Outlet Obstruction (Pyloric and Antral Atresia and Web)

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