El tamaño de la oliva y su relación con el cuadro clínico en pacientes con estenosis hipertrófica del píloro

Introduction: The pyloric “olive” (PO) is the result of theanomalous growth of the pyloric muscle among patients withpyloric stenosis (PS). It frequently is unexpectedly large, or someother times surprisingly small, and those variations in size havebeen difficult to explain.Material and methods: We...

Descripción completa

Detalles Bibliográficos
Autor: Alejandro V. Gómez-Alcalá
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2005
País:México
Institución:Instituto Mexicano del Seguro Social
Repositorio:Redalyc-IMSS
OAI Identifier:oai:redalyc.org:66273104
Acceso en línea:https://www.redalyc.org/articulo.oa?id=66273104
Access Level:acceso abierto
Palabra clave:Medicina
pylorus
pyloric stenosis
pyloric hypertrophy
Descripción
Sumario:Introduction: The pyloric “olive” (PO) is the result of theanomalous growth of the pyloric muscle among patients withpyloric stenosis (PS). It frequently is unexpectedly large, or someother times surprisingly small, and those variations in size havebeen difficult to explain.Material and methods: We measured the PO in 145 consecutivepatients with PS during the operation, and then we classifiedthem as small if their length was less than 20 mm, medium if 20 to30 mm, or large if more than 30 mm; several variables wereanalyzed by mean of the chi square or Spearman rho tests.Results: Six cases were excluded due to an unclear total lengthrecord of the PO. The PO size was classified as small in 19(13.7%), medium in 71 (51%) and large in 49 (35.3%). The POsize did not associate with gender, way of birth, the presence ofjaundice, constipation or any specific blood group or Rh factor,and it did not correlate with birth weight or month and gestationalorder either. Medium and large PO were more frequently palpatedthan smaller (94-100% vs. 83%, p= 0.009); PO size correlatedwith the duration of the history of vomiting (CQ 0.267, p = 0.002),child’s age (CQ 0.243, p = 0.005) and weight at operation (CQ0.190, p = 0.048). A daily weight loss surpassing 5 g was morecommonly found among small PO (p= 0.038).Conclusions: In more than a third of the PS patients, PO isunexpectedly large, and in one of every seven it is surprisinglysmall. The bigger PO size associates with a longer disease, andwith older and heavier patients, which probably is explained by aslighter clinical course. A small PO is more difficult to palpateduring clinical evaluation