In vivo visualization of pyloric mucosal hypertrophy in infants with hypertrophic pyloric stenosis: Is there an etiologic role?
In vivo visualization of pyloric mucosal hypertrophy in infants with hypertrophic pyloric stenosis: Is there an etiologic role?
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DOI：
10.2214/ajr.177.4.1770843
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发表时间：
2001-10-01
影响因子：
5
通讯作者：
Cywes, R
中科院分区：
文献类型：
--
作者：
Hernanz-Schulman, M;Lowe, LH;Cywes, R
OBJECTIVE.婴儿肥厚性幽门狭窄（IHPS）是出生后2-12周婴儿的常见疾病，其原因尚不清楚。在肥厚的幽门外肌层内已经发现了多种相关的异常，但迄今为止，文献中对幽门粘膜的内部成分很少关注。我们在这项研究中的目的是表明，幽门粘膜冗余是一个恒定的发现在婴儿IHPS，讨论其可能的原因，并探讨幽门粘膜冗余和IHPS.Materials和方法的发展之间的关系的假设。我们确定了102例经手术证实为IHPS的婴儿，并将幽门粘膜厚度与周围肥大肌肉厚度进行了比较。51名没有幽门狭窄的婴儿作为对照组。IHPS患者的平均粘膜厚度接近平均肌肉厚度，比值为0.89。在IHPS患儿中，幽门粘膜约占幽门肿块横截面直径的三分之一，并填充和阻塞幽门管。黏蛋白冗余是IHPS中的一个恒定相关发现。虽然起源的冗余和因果关系很难建立，我们的研究结果支持的假设，高胃泌素血症可能是牵连在发病机制的IHPS，并建议，粘膜增厚可能是牵连的起始因素之一，在其发展。
OBJECTIVE. Infantile hypertrophic pyloric stenosis (IHPS) is a common condition which presents in infants at 2-12 weeks of postnatal life, and whose cause remains obscure. Multiple associated abnormalities have been recognized within the external hypertrophied pyloric muscle layer, but the internal component of the pyloric mucosa has received scant attention in the literature to date. Our purpose in this study was to show that pyloric mucosal redundancy is a constant finding in infants with IHPS, to discuss its possible cause, and to explore the hypothesis of a relationship between pyloric mucosal redundancy and the development of IHPS.MATERIALS AND METHODS. We identified 102 consecutive infants with surgically confirmed IHPS and determined the thickness of the pyloric mucosa compared with the thickness of the surrounding hypertrophied muscle. Fifty-one infants who did not have pyloric stenosis served as controls.RESULTS. Mean mucosal thickness in patients with IHPS approximated mean muscle thickness, with a ratio of 0.89. In infants with IHPS, the pyloric mucosa constitutes approximately one third of the cross-sectional diameter of the pyloric mass and fills and obstructs the pyloric canal.CONCLUSION. Mucosal redundancy is a constant associated finding in IHPS. Although the origin of the redundancy and a cause-and-effect relationship are difficult to establish, our findings support the hypothesis that hypergastrinemia may be implicated in the pathogenesis of IHPS, and suggest that mucosal thickening could be implicated as one of the initiating factors in its development.