This animation may only be used in support of a single legal proceeding and for no other purpose. Read our License Agreement for details. To license this image for other purposes, click here.
MEDICAL ANIMATION TRANSCRIPT: Pyloric stenosis is a disease in which part of a baby's stomach is blocked or abnormally narrow. Located between the esophagus and small intestine, the stomach stores and begins to digest milk. Some of the main parts of the stomach are the fundus, the body, the pyloric region, which includes the antrum and pyloric canal, and the pylorus. The wall of the stomach contains several layers of muscle. At the end of the pyloric region, the muscle layer forms a thickened ring called the pyloric sphincter. The pyloric sphincter surrounds an opening to the small intestine called the pylorus. The pyloric sphincter is normally contracted just enough to hold milk in the stomach while contractions mix and break down the milk. From time to time, stronger waves of stomach contractions push milk out of the stomach. As the pyloric muscle relaxes, milk passes through the pylorus into the small intestine. For unknown reasons, some babies develop pyloric stenosis, in which abnormally thickened muscle layers in the pyloric sphincter block the pylorus. Stomach contractions can't push milk from the baby's stomach through the blocked pylorus. As a result, milk in the stomach can't pass into the small intestine, which causes the baby to forcefully vomit the milk. The vomiting may cause severe dehydration, a condition in which the body loses too much water. Common symptoms of dehydration include sunken eyes, no tears when the baby cries, a sunken soft spot on the top of the head, and urinating less often, or having brown or dark yellow urine. Fortunately, the dehydration is not immediately life-threatening. After the dehydration is treated, the baby will require an operation called a pyloromyotomy to open the blocked pylorus. This operation will be done a month or two after birth, when the condition is discovered. Before the operation, the baby will be given general anesthesia to put him or her to sleep for the entire operation. A breathing tube will be inserted through the nose or mouth and down the throat to help the baby breathe during the operation. Commonly, the surgeon will make three tiny incisions near or in the belly button and on the right and left sides of the upper abdomen. Then small tubes for a camera and surgical instruments will be inserted through these incisions. The surgeon will carefully locate the thickened pyloric sphincter. An incision will be made along the outside of the pyloric sphincter. The incision will only pass through the muscle layer, leaving the inner tissue lining intact. The surgeon will insert a surgical instrument to widen the incision and spread the muscle fibers apart. This incision, called a pyloromyotomy, will loosen the pyloric sphincter muscle so that stomach contractions will be able to push food through the pylorus into the small intestine. Finally, the surgeon will close the skin incisions with dissolvable sutures and skin closure strips. After the operation, the baby will be taken to the recovery room for monitoring. Pain medication will be given. Feedings will begin shortly after the operation. The baby will be released from the hospital within one to two days, once they can feed normally and stay well hydrated.
"It is my experience that it's much more effective to show a jury what
happened than simply to tell a jury what happened. In this day and age where
people are used to getting information visually, through television and
other visual media, I would be at a disadvantage using only words.
I teach a Litigation Process class at the University of Baltimore Law Schooland use [Medical Legal Art's] animation in my class. Students always saythat they never really understood what happened to [to my client] until theysaw the animation.
Animations are powerful communication tools that should be used wheneverpossible to persuade juries."
Andrew G. Slutkin Snyder Slutkin & Kopec Baltimore, MD
"[I] have come to rely upon the Doe Report and your great staff of
illustrators for all my medical malpractice cases. … Please know
that I enthusiastically recommend you to all my colleagues.
Frank Rothermel
Bernhardt & Rothermel
"The Doe Report's Do-It-Yourself Exhibits program enables easy customization
of complex medical exhibits at a reasonable expense and in a timely manner.
Practically speaking, custom medical exhibits are no longer an unthinkable
luxury, but a routine necessity."
Jack S. Cohen
Levy, Angstreich, Finney, Baldante & Coren
Philadelphia, PA
"We got a defense verdict yesterday! Your exhibit was extremely helpful in
showing the jury how unlikely it is to damage all four of the nerve branches
which control the sense of taste."
Karen M. Talbot
Silverman Bernheim & Vogel, P.C.
Philadeplphia, PA
Medical Legal Art creates medical demonstrative evidence (medical
illustrations, drawings, pictures, graphics, charts, medical animations,
anatomical models, and interactive presentations) for use during legal
proceedings, including research, demand letters, client conferences,
depositions, arbitrations, mediations, settlement conferences, mock jury
trials and for use in the courtroom. We do not provide legal or medical
advice. If you have legal questions, you should find a lawyer with whom you
can discuss your case issues. If you have medical questions, you should seek the advice of a healthcare provider.