The pyloric stenosis

The pyloric stenosis is a common complication ulcers privratnika part of the stomach and duodenum.
Given the variety of forms and causes narrowing of the pyloric area, you can be more generalized to talk about stenosis of the output section of the stomach.
In patients with severe stenosis output Department stomach expanded in all directions, which is especially clearly seen when examining the patient in the supine position. In the study in vertical positions is observed filling only the caudal Department of the stomach, which takes the form of a wide symmetric semilunar bowl with the low location of her bottom, often reaching the level of symphysis (Fig. 104). Advanced stomach contains fasting large amounts of fluid, up by pumping volume several litres. Due to the loss of tone contrast weight comes down to the bottom, rasplavami the stomach fluids.

Fig. 104. The narrowing of the output section of the stomach (called the pyloric stenosis) on the basis of ulcers.
Radiograph in 24 hours after taking barium suspension.

In this gastrectasia peristalsis has stenotic character. She deepened, her mileage slowed down, and the stomach is divided because of this from the greater curvature into several segments. After a short period of tense peristaltic activity comes a weakening of the muscles, waves, flattened and finally fade away altogether. There comes a long pause, after which appear again peristaltic waves. Sometimes defined and explicit antiperistaltic.
In the process of scanning stenosis output Department is almost never possible to observe the transition of a contrast medium into the duodenum via the stenotic area. Evacuation sharply slowed down. In the stomach there is a delay of a contrast agent through many hours after his admission. Usually for proper diagnosis is enough detection balance through 12-24 hours, but there are times when emptying of the stomach does not occur and in a few days (13 days according to our observations).
Long delay evacuation may occur in spasm privratnika, mainly on the grounds of an existing ulcer.
In the differential diagnosis regarding the origin of the pyloric stenosis involving ectasia of the stomach, is often difficult. In some cases, especially when congestive mass cannot be removed by means of suction, the question about the etiology pyloric stenosis remains open.