HYPERTROPHY of the pyloric sphincter as a source of symptoms in the adult is an uncommon but by no means rare condition. Recent extensive reviews of the literature have brought the subject up-to-date.1 Unfortunately, however, in most instances the condition has been described as more or less of a medical curiosity, and diagnosis has been insufficiently stressed. Indeed, Bockus2 has said, "A positive preoperative diagnosis of pyloric muscle hypertrophy in adults is not possible." It is my opinion, to the contrary, that this condition is associated with sufficient constant roentgenographic features to be diagnosable by the radiologist or the gastroenterologist. An increased awareness of this disease, together with an appreciation of its diagnostic criteria, will bring surgical relief to a number of patients now treated medically for vague abdominal and epigastric symptoms.
In this series of four cases the patient was usually referred to the surgeon as having