New insights on the pathogenesis of pyloric stenosis of infancy. A review with emphasis on the hyperacidity theory
New insights on the pathogenesis of pyloric stenosis of infancy. A review with emphasis on the hyperacidity theory作者机构：Surgery AIMST University Bedong Malaysia
出 版 物：《Open Journal of Pediatrics》 (儿科学期刊（英文）)
年 卷 期：2012年第2卷第2期
页 面：97-105页
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
主 题：Infantile Hypertrophic Pyloric stenosis (IHPS) Immunohistochemistry Smooth Muscle Cells Gastrin Motilin Gastrointestinal Motility Erythromycin Pyloromyotomy Acidification of the Stomach Pyloric Sphincter Function Receptor Binding Pathogenesis Antral Motility Gastric Outflow Obstruction Linkage Analysis Single Nucleotide Polymorphism: Interstitial Cells of Cahal Nitric Oxide Synthetase
摘 要：A review is presented on the theories concerning the cause of pyloric stenosis with emphasis on the primary position of inherited hyperacidity in pathogenesis. Existing theories are critically analysed and the hyperacidity theory is precisely defined in the light of recent physiological insights into the gastrointestinal hormone motilin. The progressive fixed fasting hypergastrinaemia within the first few weeks of life will, in the baby who inherits acid secretion at the top of the normal range, produce hyperacidity of sufficient severity to trigger the process of acid-induced work hypertrophy of the pylorus. The potential contribution of motilin is discussed. The baby who inherits a normal gastric acidity will not reach acid levels severe enough to trigger sphincter hypertrophy despite the early gastrin stimulus. The potential threat will cease when gastrin naturally declines with age and the pyloric canal becomes wider. Genetic factors clearly must also be involved and these are separately discussed.
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