Note 54 — Chapter XLVII · INJURIES AND SURGICAL DISEASES OF THE STOMACH.

Fiske (Annals of Surgery, July, 1906) states that there are at present on record 121 cases of hypertrophic stenosis of the pylorus in infants. The three theories advanced to account for the condition as occurring before birth presuppose either a true malformation with muscular hypertrophy, a secondary hypertrophy due to prenatal pyloric spasm, or a spastic condition of the pyloric region without definite gross anatomical lesion. None of these theories satisfies the condition in any but a small proportion of cases, although either of them doubtless is or may be correct in certain instances; 71 of these cases have now been operated upon, of which 33 died, gastro-enterostomy giving 57 per cent. of recoveries and pyloroplasty 54 percent.