Gastric foveolar cell hyperplasia and its role in postoperative vomiting in patients with infantile hypertrophic pyloric stenosis

Hock Lim Tan, A. Blythe, C. P. Kirby, R. Gent

    Research output: Contribution to journalArticle

    7 Citations (Scopus)

    Abstract

    Background: Foveolar cell hyperplasia (FCH) has been reported as a rare cause of persistent gastric outlet obstruction in patients with infantile hypertrophic pyloric stenosis (IHPS), which, if present, requires excision of the gastric foveolar folds to resolve the persistent obstruction. This is a review of patients with IHPS diagnosed on abdominal ultrasound to determine the incidence of FCH in IHPS and to evaluate whether it has a causal role in postoperative vomiting following pyloromyotomy for IHPS. Methods: The ultrasound images of all children presenting with suspected IHPS to our institution from January 2001 to May 2006 were independently reviewed by our radiology department for evidence of FCH. Three hundred and twenty-nine ultrasounds were performed during this period for suspected IHPS, and 93 cases of IHPS were diagnosed. Eleven of 93 patients with IHPS had FCH, amounting to an incidence of 12%. FCH was not seen in any of the remaining 236 patients who did not have IHPS. Results: FCH appears to be a common condition in patients with IHPS (12%) and may be responsible for postoperative vomiting. In patients in whom FCH was diagnosed preoperatively, an extended pyloromyotomy was performed in all except one patient. One patient with FCH and IHPS had persistent postoperative vomiting following extended laparoscopic pyloromyotomy but vomiting resolved after conservative measures. The only patient who underwent a non-extended pyloromyotomy by the open method was readmitted with significant persistent vomiting and underwent a second laparotomy with excision of redundant mucosa and an extended pyloromyotomy, resulting in resolution of vomiting. Conclusion: An extended pyloromyotomy appears to be adequate surgical treatment for patients with IHPS and FCH.

    Original languageEnglish
    Pages (from-to)76-78
    Number of pages3
    JournalEuropean Journal of Pediatric Surgery
    Volume19
    Issue number2
    DOIs
    Publication statusPublished - Apr 2009

    Fingerprint

    Postoperative Nausea and Vomiting
    Hyperplasia
    Stomach
    Vomiting
    Infantile Hypertrophic 1 Pyloric Stenosis
    Gastric Outlet Obstruction
    Incidence
    Radiology
    Laparotomy
    Mucous Membrane

    Keywords

    • Gastric foveolar cell hyperplasia
    • Infantile hypertrophic pyloric stenosis
    • Postoperative vomiting

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health
    • Surgery
    • Medicine(all)

    Cite this

    Gastric foveolar cell hyperplasia and its role in postoperative vomiting in patients with infantile hypertrophic pyloric stenosis. / Tan, Hock Lim; Blythe, A.; Kirby, C. P.; Gent, R.

    In: European Journal of Pediatric Surgery, Vol. 19, No. 2, 04.2009, p. 76-78.

    Research output: Contribution to journalArticle

    @article{a5cf6413209e4852914c67ea4dce0057,
    title = "Gastric foveolar cell hyperplasia and its role in postoperative vomiting in patients with infantile hypertrophic pyloric stenosis",
    abstract = "Background: Foveolar cell hyperplasia (FCH) has been reported as a rare cause of persistent gastric outlet obstruction in patients with infantile hypertrophic pyloric stenosis (IHPS), which, if present, requires excision of the gastric foveolar folds to resolve the persistent obstruction. This is a review of patients with IHPS diagnosed on abdominal ultrasound to determine the incidence of FCH in IHPS and to evaluate whether it has a causal role in postoperative vomiting following pyloromyotomy for IHPS. Methods: The ultrasound images of all children presenting with suspected IHPS to our institution from January 2001 to May 2006 were independently reviewed by our radiology department for evidence of FCH. Three hundred and twenty-nine ultrasounds were performed during this period for suspected IHPS, and 93 cases of IHPS were diagnosed. Eleven of 93 patients with IHPS had FCH, amounting to an incidence of 12{\%}. FCH was not seen in any of the remaining 236 patients who did not have IHPS. Results: FCH appears to be a common condition in patients with IHPS (12{\%}) and may be responsible for postoperative vomiting. In patients in whom FCH was diagnosed preoperatively, an extended pyloromyotomy was performed in all except one patient. One patient with FCH and IHPS had persistent postoperative vomiting following extended laparoscopic pyloromyotomy but vomiting resolved after conservative measures. The only patient who underwent a non-extended pyloromyotomy by the open method was readmitted with significant persistent vomiting and underwent a second laparotomy with excision of redundant mucosa and an extended pyloromyotomy, resulting in resolution of vomiting. Conclusion: An extended pyloromyotomy appears to be adequate surgical treatment for patients with IHPS and FCH.",
    keywords = "Gastric foveolar cell hyperplasia, Infantile hypertrophic pyloric stenosis, Postoperative vomiting",
    author = "Tan, {Hock Lim} and A. Blythe and Kirby, {C. P.} and R. Gent",
    year = "2009",
    month = "4",
    doi = "10.1055/s-2008-1039199",
    language = "English",
    volume = "19",
    pages = "76--78",
    journal = "European Journal of Pediatric Surgery",
    issn = "0939-7248",
    publisher = "Thieme Medical Publishers",
    number = "2",

    }

    TY - JOUR

    T1 - Gastric foveolar cell hyperplasia and its role in postoperative vomiting in patients with infantile hypertrophic pyloric stenosis

    AU - Tan, Hock Lim

    AU - Blythe, A.

    AU - Kirby, C. P.

    AU - Gent, R.

    PY - 2009/4

    Y1 - 2009/4

    N2 - Background: Foveolar cell hyperplasia (FCH) has been reported as a rare cause of persistent gastric outlet obstruction in patients with infantile hypertrophic pyloric stenosis (IHPS), which, if present, requires excision of the gastric foveolar folds to resolve the persistent obstruction. This is a review of patients with IHPS diagnosed on abdominal ultrasound to determine the incidence of FCH in IHPS and to evaluate whether it has a causal role in postoperative vomiting following pyloromyotomy for IHPS. Methods: The ultrasound images of all children presenting with suspected IHPS to our institution from January 2001 to May 2006 were independently reviewed by our radiology department for evidence of FCH. Three hundred and twenty-nine ultrasounds were performed during this period for suspected IHPS, and 93 cases of IHPS were diagnosed. Eleven of 93 patients with IHPS had FCH, amounting to an incidence of 12%. FCH was not seen in any of the remaining 236 patients who did not have IHPS. Results: FCH appears to be a common condition in patients with IHPS (12%) and may be responsible for postoperative vomiting. In patients in whom FCH was diagnosed preoperatively, an extended pyloromyotomy was performed in all except one patient. One patient with FCH and IHPS had persistent postoperative vomiting following extended laparoscopic pyloromyotomy but vomiting resolved after conservative measures. The only patient who underwent a non-extended pyloromyotomy by the open method was readmitted with significant persistent vomiting and underwent a second laparotomy with excision of redundant mucosa and an extended pyloromyotomy, resulting in resolution of vomiting. Conclusion: An extended pyloromyotomy appears to be adequate surgical treatment for patients with IHPS and FCH.

    AB - Background: Foveolar cell hyperplasia (FCH) has been reported as a rare cause of persistent gastric outlet obstruction in patients with infantile hypertrophic pyloric stenosis (IHPS), which, if present, requires excision of the gastric foveolar folds to resolve the persistent obstruction. This is a review of patients with IHPS diagnosed on abdominal ultrasound to determine the incidence of FCH in IHPS and to evaluate whether it has a causal role in postoperative vomiting following pyloromyotomy for IHPS. Methods: The ultrasound images of all children presenting with suspected IHPS to our institution from January 2001 to May 2006 were independently reviewed by our radiology department for evidence of FCH. Three hundred and twenty-nine ultrasounds were performed during this period for suspected IHPS, and 93 cases of IHPS were diagnosed. Eleven of 93 patients with IHPS had FCH, amounting to an incidence of 12%. FCH was not seen in any of the remaining 236 patients who did not have IHPS. Results: FCH appears to be a common condition in patients with IHPS (12%) and may be responsible for postoperative vomiting. In patients in whom FCH was diagnosed preoperatively, an extended pyloromyotomy was performed in all except one patient. One patient with FCH and IHPS had persistent postoperative vomiting following extended laparoscopic pyloromyotomy but vomiting resolved after conservative measures. The only patient who underwent a non-extended pyloromyotomy by the open method was readmitted with significant persistent vomiting and underwent a second laparotomy with excision of redundant mucosa and an extended pyloromyotomy, resulting in resolution of vomiting. Conclusion: An extended pyloromyotomy appears to be adequate surgical treatment for patients with IHPS and FCH.

    KW - Gastric foveolar cell hyperplasia

    KW - Infantile hypertrophic pyloric stenosis

    KW - Postoperative vomiting

    UR - http://www.scopus.com/inward/record.url?scp=67649637775&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=67649637775&partnerID=8YFLogxK

    U2 - 10.1055/s-2008-1039199

    DO - 10.1055/s-2008-1039199

    M3 - Article

    VL - 19

    SP - 76

    EP - 78

    JO - European Journal of Pediatric Surgery

    JF - European Journal of Pediatric Surgery

    SN - 0939-7248

    IS - 2

    ER -