The darkened spots are due to pigmented matter, and this is generally most marked in the pyloric half of the stomach.
Sometimes with dilatation of the stomach the pyloric orifice is found abnormally small, without any thickening or other appreciable change in the walls of the pylorus.
A very nice question in differential diagnosis as between pyloric carcinoma and pyloric or duodenal ulcer is sometimes raised in this way.
Sometimes it is difficult to decide which of two or more cancers in the stomach is the primary growth, as in Ripley's case of ulcerated cancer of the cardiac orifice with a similar growth around the pyloric orifice.
With the exception of one case there was no marked hypertrophy of the muscular coat of the stomach, such as is usually found with benign pyloric stenosis and would naturally be expected with a stenosis existing since birth.
Adhesions of pyloric cancers are found in at least two-thirds of the cases, and probably oftener.
This part in contact with the anterior abdominal walls corresponds to a part of the body and of the pyloric region of the stomach, and belongs to the epigastric region.
Next in frequency are cicatricial growths resulting from simple ulcer involving the pyloric region.
Footnote 97: Mikulicz has observed with the gastroscope in a case of pyloric cancer immobility of the pylorus and absence of rugae in the mucous membrane of the pyloricregion (Wiener med.
When the duodenum is the part affected by extension from the pylorus, the symptoms are indistinguishable from ordinary pyloric cancer.
Here it may be added that the propriety of resection is less open for dispute in cases of non-cancerous pyloric stenosis than it is in cancer of the pylorus.
Metastases and adhesions were absent in only 5 out of 52 cases of pyloric cancer in which either pylorectomy or exploratory laparotomy was performed (Rydygier).
Changes in the shape of the stomach and the weight of the tumor may cause displacements of pyloric cancers, so that these tumors have been found in nearly all regions of the abdomen, and even in the true pelvis.
Pyloric cancers which receive a marked pulsation from the aorta sometimes raise a suspicion of aneurism, but the differential diagnosis is not usually one of great difficulty.
Lastly, the process of cicatrization may be followed by the same disasters as occur in pyloric ulcers in consequence of contraction and constriction.
The gastritis was more marked in pyloric portion, and the inflammatory condition extended along the whole course of small intestines, which presented numerous hemorrhagic areas, and a thick catarrhal exudate on the mucosa.
Stomach presented a severe inflammation of the mucosa, especially in the fundus and pyloric portions.
These pass into the gizzard, or pyloric division of the bird's stomach, where they are utilized, the same as we utilize our buhrstones.
This would certainly be the case if they were retained for any length of time in the pyloric division of the bird's stomach.
The stomach itself was filled with blood and there was a generalized ecchymotic appearance of the mucosa, with small, submucous hematomata and a number of tears in the pyloric portion.
Re vomiting, Roussy and Lhermitte state that this relatively common condition is diagnosticated readily enough but that pyloric ulcer and other organic causes must be eliminated.
Its opening into the duodenum is provided with a very distinct pyloric valve (py.
The proximal part of the duodenum and the terminal part of the intestine are represented as cut open, the former to shew the pyloric valve and the apertures of the pyloric caeca and bile duct, and the latter to shew the spiral valve.
We have first noticed the pyloric caeca arising as outgrowths of the duodenum in larvae of about three weeks old, and they become rapidly longer and more prominent (Plate 40, fig.
The pancreas at a later stage is placed immediately behind the end of the liver in a loop formed by the pyloric section of the stomach (Plate 40, fig.
Close to the pyloric valve, on its right side, is a small papilla, on the apex of which the bile duct opens (b.
This portion of the small intestine is no doubt homologous with the still more elongated and coiled portion of the small intestine in Lepidosteus placed between the chamber into which the pyloric caeca, &c.
Cancer spread over a large area and cirrhosis of the stomach wall cause diminution in capacity; pyloric obstruction, weakness of the muscular coat, and nervous influences are associated with dilatation.
In addition, the stomach may be displaced downwards as a whole, a condition known as gastroptosis: if the pyloric portion only be displaced, the lesion is termed pyloroptosis.
Hypertrophy of the muscular coat of the pyloric region is an infrequent congenital gastric anomaly in infants, preventing the passage of food into the bowel, and causing death in a short time.
The most common situation for cancerous growth in the stomach is the pyloric region.
At thepyloric end of the stomach the alimentary canal becomes again a slender tube called the small intestine.
When the food, thoroughly mixed with saliva, reaches the stomach, the cardiac end of that organ is closed as well as the pyloric valve, and the muscular walls contract on the contents.
In mammals, the primitive form of the stomach consists of a more or less globular or elongated expansion of the oesophageal region, forming the cardiac portion, and a forwardly curved, narrower pyloric portion, from which the duodenum arises.
These are outgrowths of the intestinal tract near the pyloric extremity of the stomach, and their function is partly glandular, partly absorbing.
In the Sirenia the stomach is divided by a constriction into a cardiac and a pyloric portion, and the latter has a pair of caeca.
Before reaching this there is a bulging known as the pyloric vestibule (see D.
The fourth or true pyloric chamber is an elongated sac with smooth glandular walls and is the abomasum, or rennet sack.
From the cardiac to the pyloric orifice, round the lower border, is the greater curvature.
At nearly the first third of its length this communicates by a narrow aperture into the elongated, relatively narrow pyloric portion.
A set of organs peculiar to fish and known as the pyloric caeca are absent in Cyclostomata and Dipnoi, in most Selachii and in Amia, but present, in numbers ranging from one to nearly two hundred, in the vast majority of fish.
In the Cyclostomata, Holocephali and a few Teleostei the course of the gut is practically straight from the pyloric end of the stomach to the exterior, and there is no marked differentiation into regions.
In many other mammals one, two or three protrusions of the cardiac region occur, whilst in the manatee and in some rodents the cardiac region is constricted off from the pyloric portion.
There is a possibility that some of these cases of Hippocrates were instances of pyloric carcinoma or of stenosis of the pylorus.
The second case was that of a man in whom almost the entire stomach was removed, and the pyloric and cardiac ends were stitched together in the wound of the parietes.
A postmortem was made five hours after death, and there was so much destruction of the stomach by a process resembling digestion that only the pyloric and cardiac orifices were visible.
A necropsy showed a rupture two inches long and two inches from the pyloric end.
As the food mass is made alkaline in the presence of the intestinal juices, the pyloric valve closes, opening again as the contents nearest it on the stomach side are acidified.
The pyloric end of the stomach exhibits strong peptonizing powers and much of the hydrolysis of protein takes place here.
The opening of this sphincter is controlled, according to Cannon, to a certain extent by the liquefication of the chyme, but more especially by the presence of free acid in the stomach side of the pyloric orifice.
After the discharge the pyloric muscle again contracts, and so remains until the time arrives for another discharge.
This action varies in different parts of the organ, being slight or entirely absent at the cardiac end, but quite marked at the pyloric end.
During these contractions the pyloric valve is closed, and the muscles of the esophagus and pharynx are in a relaxed condition.
The circular layer becomes quite thick at the pyloric orifice, forming a distinct band which serves as a valve.
At its upper extremity it connects with the pyloric end of the stomach (Fig.
Its connection with the esophagus is known as the cardiac orifice and its opening into the small intestine is called the pyloric orifice.
During the greater part of the digestive period the muscular band at the pyloric orifice is contracted.
A series of experiments carried out with dogs under anesthesia, by injecting Bovinine into the stomach, the pyloric end of which was ligated, shows that Bovinine is not readily absorbed and assimilated by the stomach as claimed.
Attached near the pylorus and pouring their secretions into the duodenum or small intestine are the pyloric caeca.
If we cut the fish open, we shall find the stomach with its pyloric caeca, near it the large liver with its gall-bladder, and on the other side the smaller spleen.
The stomach has the form of a blind sac, and at its termination are a number of tubular sacs, the pyloric caeca, which secrete a digestive fluid.
The stomach is more specialised than in other Insectivores, the pyloric region being extended as a narrowish tube.
The Rodents have for the most part a simple stomach of normal form; but in a few this is complicated by a marked constriction, which divides the cardiac from the pyloric portions.
The pyloric region of the stomach is extended and twisted upon itself.
The oesophagus enters the stomach near the pyloric end of that organ.
Schaefer and Williams[77] have shown that the squamous, non-glandular epithelium of the oesophagus extends over the greater part of the stomach, only the pyloric extremity and one of the two cardiac caeca being lined with columnar epithelium.
The alimentary canal is straight for its whole length, without pyloric cæca.
In the rivers they do not feed; and when they reach the spawning grounds their stomachs, pyloric cœca and all, are said to be no larger than one's finger.
The chief essential difference lies in the form of the stomach, which is a blind sac, the two openings near together, and about the second or pyloric opening there are few if anypyloric cæca.
Stomach cæcal, with pyloric appendages, the intestines short in most species, long in the herbivorous forms.
The scales are small, and the dorsal fin far back and opposite the anal, and the stomach is without pyloric cæca.
In all the Salmonidæ the stomach has the form of a siphon, and about the pylorus there are very many pyloric cæca.
It was found that shortly after food reached the stomach a series of waves began which sent the food toward the pyloric end of the stomach.
These structures, called the pyloric caeca, are believed to secrete a digestive fluid.
Ultimately the semifluid food, much of it still undigested, is allowed to pass in small amounts through the pyloric valve, into the small intestine.
The stomach is similar to that of Myrmecophaga, but with the muscular pyloric gizzard less strongly developed.
Stomach consisting of a sub-globular, thin-walled, cardiac portion, and a muscular pyloric gizzard with dense epithelial lining.
The pyloric end is said to have been of a blackish colour, and no lymph was exuded.
There is extensive destruction of mucous membrane along the lesser curvature and towards the pyloric extremity; a portion of the mucous membrane is floating as a slough.
The stomach is contracted, the mucous membrane of the lower part of the gullet, the lesser curvature, and the pyloric end of the stomach is extensively corroded, showing ulcerated patches commencing to cicatrize.
The stomach was constricted at the pyloric end, so that it would scarcely admit a quill.
In a case of poisoning by verdigris (subacetate of copper) recorded by Orfila,[883] the stomach was so much inflamed and thickened that towards the pyloric end the opening into the intestine was almost obliterated.
After digestion has been going on in the stomach for some time, the semi-digested food, in the form of chyme, begins to pass through the pyloric orifice of the stomach into the duodenum, or upper portion of the small intestine.
Here it is gradually dissolved, and then carried into the pyloric portion of the stomach.
When the food is reduced to a liquid condition, it accumulates in the pyloric portion of the stomach.
The stomach is between the liver and spleen, subjacent to the diaphragm, and communicates with the intestinal canal by the pyloric orifice.
Stomach and mid-gut of Gadus callarias, codfish, in section, showing intestinal openings of pyloric caeca.
At the pyloric extremity the muscle wall is greatly increased and the mucous membrane of this portion carries a thick horny covering, forming a masticatory stomach greatly resembling the corresponding structure in the bird.
Stomach and mid-gut withpyloric caeca and hepatic duct.
The stomach is differentiated both by its caliber and by the formation of a pyloric ring valve.
The oesophageal or cephalic end is placed to the left of the median line, while the caudal or pyloric end is situated on the right side (Figs.
The transverse segment of the omentum, attached on the liver to the portal or transverse fissure, accedes to the pyloricpart of the lesser curvature.
At this time the stomach presents right and left surfaces, and the oesophageal entrance is at the highest or cephalic point of the organ, while the pyloric transition to the small intestine occupies the distal caudal extremity.
On the other hand in some forms the number ofpyloric appendices is enormously increased, while their caliber diminishes.
Trace in the first place the entire course of the intestinal tube from the pyloric extremity of the stomach down.
Consequently there must always be a narrow peritoneal neck between the liver cephalad, aorta dorsad, hepatic artery caudad, and pyloric extremity of stomach and duodenum together with the lesser omentum ventrad.
The pyloric appendices apparently have the same significance as the spiral intestinal fold of the Selachians, Cyclostomes and Dipnoeans, i.
These are the pyloric caeca, whose function is to secrete the digestive fluids.
If thepyloric caeca be laid back, one can see the rib-like arrangement of the ambulacral ossicles, and also the ampullae, which lie between the ossicles on each side of the ridge.
Pyloric caeca are close to the stomach, and vary in number; there are even some, like the majority of the cartilaginous fishes, which have none whatever.
In the Teleostomi one or more glandular diverticula commonly occur at the commencement of the intestine and are known as the pyloric caeca.
The intestine is usually marked off from the stomach by a ring-like sphincter muscle forming the pyloric valve.
