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Stomach

Non-neoplastic anomalies

Pyloric stenosis

Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 28 July 2012, last major update July 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Congenital or acquired

Congenital pyloric stenosis

General
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● Common congenital abnormality (1 per 300-900 births)
● 75% male, onset at 3-12 weeks, high concordance in monozygotic twins, associated with Turner’s syndrome, trisomy 18, esophageal atresia

Clinical features
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● Persistent projectile non-bilious vomiting in second week of life
● Regurgitation, visible peristalsis

Treatment
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● Pyloromyotomy (splitting of pyloric muscle)

Gross description
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● Thickened pyloric muscle resembling a fusiform mass, 3-5 cm, that occludes the pyloric channel

Gross images
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Hypertrophic pyloric stenosis

Micro description
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● Edema and inflammatory changes in mucosa or submucosa
● Thickening primarily of circular muscle, which terminates abruptly distally

Acquired pyloric stenosis

General
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● 80% men, hypertrophy of pyloric circular muscle fibers that ends at duodenum
● Associated with antral gastritis or pyloric ulcer

Differential diagnosis
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● Linitis plastica adenocarcinoma

End of Stomach > Non-neoplastic anomalies > Pyloric stenosis

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