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Adult Hypertrophic Pyloric Stenosis Managed by Double Pyloroplasty

George J. Brahos, MD; Eberhard Mack, MD
JAMA. 1980;243(19):1928-1929. doi:10.1001/jama.1980.03300450042021.
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HYPERTROPHIC pyloric stenosis is a relatively rare cause of gastricoutlet obstruction in adults. Although various classifications and possible causes have been described,1 when the secondary forms are eliminated, there remains an entity that appears to be distinct and truly congenital in origin.1-4 As in infants with the congenital form, the pylorus in the adult disorder is characterized by thickening and hypertrophy of the pyloric muscle, but with absence of fibrosis, which would imply inflammation.1 The two conditions differ mainly in that obstructive symptoms in the adult form become manifest much later in life.

Infantile hypertrophic pyloric stenosis is well known, and its surgical management seems clearly defined. However, probably because experience is limited, the most appropriate surgical approach for the adult form is as yet undetermined. We describe a case that is, to our knowledge, the first to be managed by the double pyloroplasty technique, and it


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