Pyloric stenosis

Of the proximate derivatives of atropine, the methobromide and the methonitrate are in use for much the same purposes as atropine, but the methonitrate has received special attention for the treatment of pyloric stenosis. opoAtropine has been found by Mancini to retain the same type of action as atropine but to be less potent in peripheral and more active in central nervous action. ... 

Low level of NO involved in causation of pylorospasm in infantile hypertrophic pyloric stenosis... 

Furthermore, pH determination has been used in other clinical research, both alone and in combination with other measurements. This research includes studies into the relationship between extracellular and intracellular pH in an ischemic heart [6, 7], the pH of airway lining fluid in respiratory disease [8], the study of pH as a marker for pyloric stenosis [9], malnutrition in alkalotic peritoneal dialysis patients [10], pH modulation of heterosexual HIV transmission [11, 12], and wound prevention and treatment [13], In addition, pH changes due to blood acidosis have been used to trigger and pace the ventricular rate of an implanted cardiac pacemaker [14], Research using pH measurements... 

E.A. Oakley and P.L. Barnett, Is acid base determination an accurate predictor of pyloric stenosis J. Paediatr. Child Health 36, 587-589 (2000). 

Urinary/Gastric retenf/on Administer with caution to patients with clinically significant bladder outflow obstruction because of the risk of urinary retention and to patients with Gl obstructive disorders, such as pyloric stenosis, because of the risk of gastric retention. 

Pyloric stenosis Patients with pyloric stenosis may have prolonged gastric retention of balsalazide capsules. 

Contraindications Coronary insufficiency, pyloric stenosis, glaucoma, uremia, recent myocardial infarction, unreliable patients... 

Acetylcholine-blocking drugs should be avoided in patients with prostatic hyperplasia, obstructive gastrointestinal disease (eg, pyloric stenosis or paralytic ileus), or angle-closure glaucoma. In parkinsonism patients receiving antimuscarinic medication, concomitant administration of other drugs with antimuscarinic properties (eg, tricyclic antidepressants or antihistamines) may precipitate some of the complications mentioned above. 

F7. Forbes, G. B., and Erganian, J. A., Parenteral administration of ammonium chloride for alkalosis of congenital Pyloric stenosis. A.M.A. J. Diseases Children 72, 649 (1946). 

Serious, quantitative discussion of specific conditions is premature. We are concerned mainly with overall numbers. But it is instructive to consider one example to show the complexities that ultimately will have to be taken into account. Pyloric stenosis is a failure of the pyloric... 

ABI 7-3 Risk of Pyloric Stenosis in Persons with Relatives Who Had Pyloric Stenosis... 

Gastrointestinal Effects. A man swallowed an unspecified amount of benzene and survived, but developed an intense toxic gastritis and later pyloric stenosis (Greenburg 1926). 

Features include muscle weakness and cramps, paraesthesia, nausea, vomiting, constipation, abdominal pain, polyuria, polydipsia, depression, confusion and psychosis. Hypokalaemia may cause brady/tachyarrhythmias, hypotension, respiratory failure, ileus and altered mental state. It also increases the toxicity of cardiac glycosides. There are several associated disease states (e.g. diarrhoea, vomiting, renal tubular acidosis types I and II, hypomagnesaemia, Conn s syndrome, Cushing s disease, Gitelman s syndrome, villous adenoma, pyloric stenosis, intestinal fistulae). 

Enteric coating reduces the rate of absorption of aspirin. In cases of severe overdosage this can cause difficulties in diagnosis and treatment, since early plasma salicylate measurements are unreliable, maximum blood concentrations sometimes not being reached until 60 or 70 hours after overdose (94,95). Another complication of the use of enteric-coated aspirin is the risk of gastric outlet obstruction and the resulting accumulation of tablets because of subclinical pyloric stenosis. 

Severe copper deficiency has followed the intake of a gel containing bismuth, aluminium, magnesium, and sodium in a patient with pyloric stenosis (44). 

Anticholinergic drugs clearly may cause problems in patients with closed-angle glaucoma (or a narrow angle between the iris and cornea), paralytic ileus, pyloric stenosis, or urinary retention. Because of their effects on temperature control they may be undesirable in patients with pyrexia (especially children) and during very hot weather. 

The clinical and biological effects and safety of urso-deoxychohc acid in intrahepatic cholestasis of pregnancy have been reported in 19 patients, 14 of whom had clinical improvement, with reduction or disappearance of pruritus, and 11 of whom had an improvement in biochemical hver function tests (13). The only birth defect reported was pyloric stenosis in a boy whose mother had taken ursodeoxychohc acid for 10 days at 34 weeks gestation. 

Pylorospasm and hypertrophic pyloric stenosis is associated with early postnatal erythromycin exposure and has been observed in neonates after 1-2 days of oral erjdhromycin therapy (30). The prominent gastrokinetic properties of erythromycin have been postulated as the mechanism (31). 

Pyloric stenosis has also been reported in a boy born... 

The use of erythromycin in postexposure prophylaxis for pertussis in 200 infants was followed by an increased number of cases of infantile hypertrophic pyloric stenosis, and all seven cases had taken erythromycin prophylacti-cally (33). A case review and cohort study supported these preliminary findings (34). In a retrospective study in 314 029 children, very early exposure to erythromycin (at 3-13 days of life) was associated with a nearly eightfold increased risk of pyloric stenosis (35). There was no increased risk in infants exposed to erythromycin after 13 days of hfe or in infants exposed to antibiotics other than erythromycin. 

In a retrospective study there was no evidence of an increased risk of pyloric stenosis among infants bom to mothers exposed to erythromycin during pregnancy (57). 

SanFilippo A. Infantile hypertrophic pyloric stenosis related to ingestion of erythromycine estolate A report of five cases. J Pediatr Surg 1976 11(2) 177-80. 

Hauben M, Amsden GW. The association of erythromycin and infantile hypertrophic pyloric stenosis causal or coincidental Drug Saf. 2002 25(13) 929 2. 

Centers for Disease Control and Prevention (CDC). Hypertrophic pyloric stenosis in infants following pertussis prophylaxis with erythromycin—Knoxvihe, Tennessee, 1999. MMWR Morb Mortal Wkly Rep 1999 48(49) ... 

Honein MA, Paulozzi LJ, Himelright IM, Lee B, Cragan JD, Patterson L, Correa A, Hall S, Erickson JD. Infantile hypertrophic pyloric stenosis after pertussis prophylaxis with erythromcyin a case review and cohort study. Lancet 1999 354(9196) 2101-5. 

Cooper WO, Griffin MR, Arbogast P, Hickson GB, Gautam S, Ray WA. Very early exposure to erythromycin and infantile hypertrophic pyloric stenosis. Arch Pediatr Adolesc Med 2002 156(7) 647-50. 

Hussain N, Herson VC. Erythromycin use during pregnancy in relation to pyloric stenosis. Am J Obstet Gynecol 2002 187(3) 821-2 author reply 822. 

In a case-control surveillance of congenital abnormahties in 22 865 women who had neonates or fetuses with congenital abnormalities, and 38 151 pregnant women who had neonates without any defects, treatment with nalidixic acid during pregnancy was associated with an increased risk of pyloric stenosis (29). Nalidixic acid should be avoided during pregnancy. 

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