The Pyloric Sphincteric Cylinder in Health and Disease

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Chapter 24 (page 117)

The Pathogenesis and Etiology

Belding and Kernohan (l953) found that in both IHPS and AHPS the number of myenteric ganglion cells and myenteric nerve fibre tracts per unit area of muscle tissue showed a decrease in the affected pyloric region; the majority of myenteric ganglion cells also showed degenerative changes. The hypertrophied circular muscle had a disorganized pattern, and it appeared if there were primary changes in both the myenteric ganglia and the musculature.

Skoryna et al. (l959) suggested that a congenital neuro-muscular dysfunction of the "pyloric canal mechanism" formed a common basis for both IHPS and AHPS; in the former there was a lack of normal regression of the circular musculature of the pyloric canal during early infancy, while in the latter other factors in adult life were involved.

According to Edwards (l96l) the etiology remained uncertain; persistence of the infantile form, degeneration of myenteric plexuses and long continued pylorospasm had to be considered as possible causes. Keynes (l965) and du Plessis (l966) were unable to confirm the presence of abnormal ganglion cells in the myenteric plexuses.

Heinisch (l967) held that macroscopically and microscopically AHPS could not be differentiated from IHPS, and that the pathogenesis and etiology of both remained obscure.


  1. Bateson EM, Talerman A, Walrond ER. Radiological and pathological observations in a series of seventeen cases of hypertrophic pyloric stenosis of adults. Brit J Rad l969, 42, 1-8.
  2. Belding HH, Kernohan JW. A morphologic study of the myenteric plexus and musculature of the pylorus with special reference to the changes in hypertrophic pyloric stenosis. Surg Gynaec Obstet l953, 97, 322-334.
  3. Bodon GR, Haake PW. Hiatus hernia and pyloric hypertrophy in the adult. Surgery l968, 63, 430-433.
  4. Christiansen KH, Grantham A. Idiopathic hypertrophic pyloric stenosis in the adult: a review of the literature and the report of two cases. Arch Surg l962, 85, 207-214.
  5. Cole LG. The living stomach and its motor phenomenon. Acta Rad l928, 9, 533-545.
  6. Craver WL. Hypertrophic pyloric stenosis in adults. Gastroenterology l957, 33, 914-924.
  7. Cunningham DJ. The varying form of the stomach in man and the anthropoid ape. Trans Roy Soc Edinb l906, 45, 9-47.
  8. Desmond AM, Swynnerton BF. Adult hypertrophy of the pylorus. Brit Med J l957, l, 968-971.
  9. Du Plessis DJ. Primary hypertrophic pyloric stenosis in the adult. Brit J Surg l966, 53, 485-492.
  10. Edwards D. Some radiological aspects of pyloric disease. Proc Roy Soc Med l96l, 54, 933-937.
  11. Forssell G. Über die Beziehung der Röntgenbilder des menschlichen Magens zu seinem anatomischen Bau. Fortschr Geb Röntgenstr l913, Suppl 30, 1-265.
  12. Heinisch HM. Die sogenannte Pylorushypertrophie im Tierversuch. Klin Wochenschr l967, 45, 1251-1252.
  13. Horton BT. Pyloric musculature, with special reference to pyloric block. Amer J Anat l928, 41, 197-225.
  14. Horwitz A, Alvarez WC, Ascanio H. The normal thickness of the pyloric muscle and the influence on it of ulcer, gastroenterostomy and carcinoma. Ann Surg l929, 89, 521-528.
  15. Keynes WM. Simple and complicated hypertrophic pyloric stenosis in the adult. Gut l965, 6, 240-252.
  16. Kirklin BR, Harris MT. Hypertrophy of the pyloric muscle of adults: a distinctive roentgenologic sign. Amer J Roentg Rad Ther Nucl Med 1933, 29, 437-442.
  17. Knight CD. Hypertrophic pyloric stenosis in the adult. Ann Surg l96l, 153, 899-910.
  18. Larson LJ, Carlson HC, Dockerty MB. Roentgenologic diagnosis of pyloric hypertrophy in adults. Amer J Roentg Rad Ther Nucl Med l967, 101, 453-458.
  19. Levin B. Miscellaneous gastric lesions. Sem Roentg l97l, 6, 193- 206.
  20. Lumsden K, Truelove SC. Primary hypertrophic pyloric stenosis in the adult. Brit J Rad l958, 31, 261-266.
  21. McNaught GHD. Simple pyloric hypertrophy in the adult. J Roy Coll Surg Edinb l957, 3, 35-41.
  22. Morton CB. Hypertonicity with hypertrophy of the pylorus in adults: surgical aspects. Arch Surg l930, 20, 508-514.
  23. North JP, Johnson JH. Pyloric hypertrophy in the adult. Ann Surg l950, 131, 316-329.
  24. Schuster MM, Smith VM. The pyloric "cervix sign" in adult hypertrophic pyloric stenosis. Gastroint Endosc l969, 16, 210-211.
  25. Seaman WB. Hypertrophy of the pyloric muscle in adults: analysis of 27 cases. Radiology l963, 80, 753-764.
  26. Skoryna SC, Dolan HS, Gley A. Development of primary pyloric hypertrophy in adults in relation to the structure and function of the pyloric canal. Surg Gynaec Obstet l959, 108, 83-92.
  27. Torgersen J. The muscular build and movements of the stomach and duodenal bulb. Acta Rad l942, Suppl 45, 1-191.
  28. Truesdale PE. The pylorus: observations upon its musculature. Surg Gynaec Obstet l9l5, 21, 298-303.
  29. Wieser C, Allgöwer M, Flury A et al. Die gutartige Pylorushypertrophie des Erwachsenen im Röntgenbild. Radiol Clin l963, 32, 277- 291.

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