Pyloric atresia: authors’ clinical experience and literature review

Abstract

Introduction. Congenital pyloric atresia is a rare malformation of the stomach outlet which amounts to about 1% of all atresias in the gastrointestinal tract. The gastric outlet atresia may be either isolated or combined with other abnormalities.Material and methods. There are few publications on the surgical treatment of pyloric atresia with extraluminal and intraluminal endoscopic interventions; however, at present information about it is not enough to assess their effectiveness and safety in young children. In literature, one can also find only few detailed reviews on clinical observations of pyloric atresia; most of which describe anatomical type I. Membranectomy and pyloroplasty are used for surgical treatment of pyloric atresia of type I. Surgery for pyloric atresias of types II and III which includes the resection in atresia zone and the formation of anastomosis between the stomach and duodenum causes complications due to the duodeno-gastric reflux in postoperative period. To prevent these complications, there is a surgical technique which was first described by A. Dessanti, et al. and later was modified and detailed by S. Yokoyama. This article is a literature overview on the topic and authors’ own experience in treating pyloric atresia of type II in 2 patients and of type I in one 1 patient.Conclusion. The choice of surgical approach depends on the anatomical type of pyloric atresia. Currently, there is no any unified approach to the surgical treatment of atresia of types II and III. Membranectomy and gastroduodenoanastomosis seem to be the most appropriate surgical techniques to correct this abnormality what has been confirmed by our preliminary findings.