eemydye jarameny
|
 |   Related post: circumstance, and that it may become persistent by a continuance of action of conditions such as food composition and reaction, and also constitutional excitability, which do not obtain in the adult. In pylorus spasm with a relative stenotic condition of the lumen of the pylorus, the vomiting may begin soon after birth, or be delayed two or three weeks or more. In some children there is a history of previous well being, the stools even having been normal, when some slight change took place in the feeding. Either an attempt was made to supple- ment the breast with a bottle feeding, or, as in one of my cases, the mother in pure jest allowed the child to nurse at another woman's breast. The vomiting dated from that time and persisted and increased in severity. The vomiting in cases of spasm of the pylorus is as "explosive" as in cases of hypertrophy, the constipation is marked, the in- anition also is progressive. Peristalisis is present to a marked degree, and in the very marked cases, the pylorus can be felt when the stomach is in a condition of contraction as a small body the size of a white bean, or as large as the phalanx of the finger, and in the cases which I will bring forward, as new- cases in this paper, could be felt to relax and then harden at the moment of contraction of the pyloric portion of the Loperamide Mg stomach. When the pylorus was soft it could be felt quite distinctly and when it hard- ened the pyloric end of the stomach was visible on the abdominal wall in the state of peristalsis, Buy Cheap Loperamide and vomiting occurred. Thus in these cases there was "explosive" vomit- ing, stomach peristalsis, and a palpable pylorus. It Copyright, 1913, by A. R. Elliott Publishing Company. 58 KOPLIK: SPASM OF PYLORUS. [New York Medical Journal. is in this latter point the various authors are not in accord as to their conclusions of the conditions present. With some the fact that any pylorus is palpable argues the presence of a thickening or hy- pertrophy (Ibrahim) ; with others this structure is simply that of a contracting muscular organ, just as one might feel the biceps more distinctly if it was contracted. I think the pylorus is a contractile or- Buy Loperamide gan, and when in a state of diastole it may be soft though palpable, like the rest of the intestine when contracted it may be felt. The fact that it is felt is no argument in favor of any hypertrophy of its structure. I think, therefore, that in cases of spasm of the pylorus or pyloric end of the stomach there may be a relative stenosis, which may either be complete or nearly so, a palpable tumor indicating the contracting pylorus. My classification of all of the cases of this affection is as follows : i. Pure spasm of the pylorus and the pyloric end of the stomach without any palpable pylorus, with peristalsis and explosive vomiting, loss of weight, and consequent inanition. The constipation present may be only a relative constipation, that is, some fecal matter passes, or there may be several move- ments, green and fluid in twenty-four hours, or of a brownish color, or the constipation may be abso- lute and on forced movement of the bowels, little or no fecal matter passes. 2. Pyloric Loperamide 2 spasm with relative and actual steno- sis, with slight or marked thickening or hyper- trophy of the tissues of the pylorus. Such cases give vomiting Purchase Loperamide Online of an explosive type, coming on soon after birth, and continuing for Buy Loperamide Online some time with a palpable pylorus, at first, or subsequent to the onset of symptoms. The pylorus can be felt to harden under the finger at the time of greatest Loperamide 2 Mg peristalsis of the stomach, and to soften after vomiting has occurred. There is constipation, complete at first, which after some duration of the disease mitigates, and fecal particles may appear in the stools. There is marked progressive atrophy and inanition. 3. Congenital hypertrophy of the pylorus so called with stenosis. These cases, which are only relatively more marked in their symptomatology than the pre- vious class, give exactly the same symptoms ; there Loperamide Online is the same spasm of the pylorus as an accompany- ing symptom, the pylorus can be felt just as in the previous class, the peristalsis is just the same, and the constipation is the same, only possibly more marked. In fact, clinically it is the same condition, only it may manifest itself in more aggravated forms than in the cases in which the hypertrophy and stenosis are not so marked. I think, therefore, they arc practically the Order Loperamide Generic Loperamide same set of cases as in Class 2. When operated the cases in Class 3 may show con- siderable enlargement and hardening of the pylorus than was evident before the operation. This has given rise to the presumption that they are a dis- tinct entity apart from Class 2. This, I doubt, — I think both these sets of cases merge into each other and are pathologically the same, Loperamide Immodium though clinically one seems a more aggravated condition than the other. Case I. Congenital hypertrophy of the pylorus with stenosis (hypertrophic stenosis). H., male, six weeks of Order Loperamide Online age. Mother had two healthy children. Weight at birth nine pounds seven ounces. The infant had a convulsion after birth and was at first fed on the bottle, and then placed with a wet nurse. Normal in other respects at birth. Lost one pound the first week after birth, weighing eight pounds 6.5 ounces on the fourteenth day. He still weighed eight pounds 6.5 ounces (stationary weight) at the end of the third week, being still on artificial feeding, and weighing eight pounds eight ounces he was placed with a wet nurse. At the beginning of the second week he began to vomit, vomiting the whole or Cheap Loperamide part of every feeding and more in quantity than he had nursed. There was complete constipation, no feces passing. He did not im- prove with a wet nurse, and when I saw him "in his fifth week he weighed eight pounds. The milk of the wet nurse at this time contained seven per cent, of fat, and was scanty. At six weeks of age he weighed seven pounds seven ounces. He vomited from two to three ounces of every feeding, and had about four large vomiting spells in twenty-four hours, and in twenty-f«ur hours ran down to seven pounds seven ounces in weight and had a most marantic appearance. Examination showed a most marked and gigantic peristalsis, not only at times of vomiting, but in intervals of Purchase Loperamide nursing. The pylorus could be distinct- ly felt as a hard body the size of the last phalanx of the small finger. He cried as if in pain when vomiting oc- cured, and was constipated to an extreme degree. When enemata were given a dark brownish water returned; there Related links: Cytotec 800 Mg, Doxycycline 100mg Acne, Buy Ziagen, 200 mg zoloft too much, Diphenhydramine Buy, Cheap Ranitidine, Saw Palmetto Hair Growth, prozac sales, Buying Diflucan Online, Can I Take Ibuprofen With Celebrex
|