The medical diseases of children . h side, but comes to an abrupt endon the duodenal side (Fig. 51). The pylorus after death easily allowsof the passage of a small quill. 262 DISEASES OF THE DIGESTIVE SYSTEM The mucous membrane very constantly shows signs of gastritis,and is either reddened and injected, or grey and sodden, in appearance,and is covered by a variable amount of mucus. In the pylorus themucosa is thrown into longitudinal folds, usually three in is to be noted that the pyloric mucosa, as seen at operations,appears very congested and cedematous. The condition of the small
The medical diseases of children . h side, but comes to an abrupt endon the duodenal side (Fig. 51). The pylorus after death easily allowsof the passage of a small quill. 262 DISEASES OF THE DIGESTIVE SYSTEM The mucous membrane very constantly shows signs of gastritis,and is either reddened and injected, or grey and sodden, in appearance,and is covered by a variable amount of mucus. In the pylorus themucosa is thrown into longitudinal folds, usually three in is to be noted that the pyloric mucosa, as seen at operations,appears very congested and cedematous. The condition of the small intestine is important. It may becontracted and atrophic to a most remarkable degree, but whetherempty or distended with air, its walls post mortem always showmarked wasting. Associated malformations, which have been reported in a certainnumber of cases, require mention, as their occasional presence hasbeen brought forward to support the theory that the disease is dueto a congenital malformation. Such conditions as slight webbing. Fig. 50.—Hypertrophic Pyloric Stenosis :Abdominal viscera post mortem. Note pylorus tucked away behind body of stomach. of the toes, slight dilatation of the renal pelves, as well as congenitalcardiac lesions, cerebral and other cysts, have been reported: buteven where all minor abnormalities are included, the percentage ofthe cases with malformations is too small to be of any weight in theargument on the causation of the disease. The only malformationwhich is at all common is phimosis. This is ncarlv constant, andprobably accounts for the dilatation of the pelves of the kidneys whichhas been reported. Theoretical Considerations.—Of the theories which have beenadvanced to explain the origin of hypertrophic pyloric stenosis, twoonly need be considered. In the first it is supposed that at the timeof the childs birth the pyloric wall is thicker than normal, and that HYPERTROPHIC PYLORIC STENOSIS 263 from this there arises, either immediately or late
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatrics, bookyear1
