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A D V E R T I S E M E N T
A D V E R T I S E M E N T
The stomach is initially drawn to the patients left (as shown here), and then a gentle side-to-side rocking motion is employed to deliver the pylorus. It sometimes helps to push down on the abdomen around the incision to help pop the pylorus out.
A D V E R T I S E M E N T
The pylorus is shown here. The Vein of Mayo is the name of the vein crossing the duodenum at the edge of the hypertrophied pylorus - it is used as a marker. Note the pale color of the hypertrophied pylorus as compared to the stomach and duodenum - this gives you an idea of how long to make your incision.
Notes:
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A D V E R T I S E M E N T
It is critical to realize that the pylorus protrudes into the duodenum much like a cervix. Therefore, the color change that one sees is often beyond where the mucosa of the duodenum reflects back on itself. For this reason, your incision should be carried close to the color change, but not to it. Otherwise, the duodenum will be entered. If the duodenum is entered, it usually can be repaired with a simple suture or two. If a large hole is made in the duodenum, the whole incision in the pylorus should be closed, the pylorus rotated 90 to 180 degrees and a proper pyloromyotomy done.
Notes:
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This page was last modified on 6/28/1999.
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