. Diseases of the stomach : including dietetic and medicinal treatment . , but the infiltration of the wall of the pyloriccanal by dense scar tissue renders relaxation impossible. To this 352 PYLORIC SPASM AXD PYLORIC organic stenosis there is often added from time to time a spasm of thepyloric sphincter, further diminishing the himen of the orifice. Acuteinflammatory tumefaction may also appear from acute exacerbationsof the ulcerative process, and intensify the difficulty, while adhesionsbinding the pylorus to neighboring parts interfere with its mobility,and cause kinks and bends
. Diseases of the stomach : including dietetic and medicinal treatment . , but the infiltration of the wall of the pyloriccanal by dense scar tissue renders relaxation impossible. To this 352 PYLORIC SPASM AXD PYLORIC organic stenosis there is often added from time to time a spasm of thepyloric sphincter, further diminishing the himen of the orifice. Acuteinflammatory tumefaction may also appear from acute exacerbationsof the ulcerative process, and intensify the difficulty, while adhesionsbinding the pylorus to neighboring parts interfere with its mobility,and cause kinks and bends which further increase the mechanicalobstruction. It is important to remember that in the healing of ulcer anyor all of these stenosing factors may he present in combination, organiccontraction, cicatricial infiltration, and perigastric adhesions beingirremediable by medical treatment, while spasm of the sphincter andinflammatory swelling may subside under appropriate lies the hope and the despair of the purely medical treatmentof the disease. Fig. 65. Benign pyloric stenosis following ulfor, from the duodenal side. (From Bloodgoods colleetion ofspecimens in the Surgical Pathological Laboratory of the .lohiis Hopkins Hospital.) Infiltration of the walls of the pyloric portion often occurs withcircumscribed cirrhosis of the stomach, with tuberculous deposits, andwith syphilitic lesions of the stomach either in the form of ulcer withinfiltrated base or with gumma or with diffuse syphilitic have been described under their respective headings. Benign tumors having their origin in this portion of the stomachmay often occlude the orifice, and are elsewhere described in detail. It has occasionally happened that polypoid tumors of the stomachwith a sufficient length of pedicle may engage in the pyloric opening,forming a ball valve which blocks the orifice completely. Obstructionof the pylorus by foreign bodies or masses of hard vegetable fibers PYLOR
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