A Case of Pyloric Stenosis

Mr. B.H.M., 67 yrs, staying at Sangamner, came on 4th Nov 2006,
a diagnosed case of Pyloric Stenosis with complaining of

C/O: Since 36 yrs, But more aggravated since 1 yrs,
Forced out Vomiting as soon as he takes anything;
<> Empty stomach, Vomiting
Pain in Stomach – Constricting, Oppressed, Spasmodic sensation; as if something coming out of it;
<> Warm Food in minimum quantity.
Associated with severe emaciation, weakness, enervation, nervousness;
So weak that not able to sit for Case Taking;
Came with Support of his Son

Past H/O:
Typhoid in childhood
Operated twice for Peptic Ulcer in 1981 & 1999

Family H/O:
Hemorrhoids – Father & Younger Brother
Ca rectum PGF Died
Ca liver Brother Died
Liver Cirrhosis Brother Died

Personal H/O:
Craving: Tobacco+
Aggravation: Onion+++
Stool: Hard; Once in two days
Sleep: Variable
Thermal: Ambi-thermal


Mental State including Life Space Investigation:
Patient was in a state of Anguish due to Pains in Stomach, looking Sad, depressed;
When asked regarding his disease, he told it’s better to die than remaining alive;
He has to get admitted every week for IV fluids due to weakness; Lot of Economical Stress; Done one attempt to suicide by consuming Sedative Pills;
Sighing intermittently when questioned;
Patient was not in a state to give details regarding Life Space Investigation due to pains;
So history is collected from his son.
Patient from Poor Socio-economic Family;
Childhood Average; Studied up to 7th std. Left school because of poverty; Still feels bad about it; started working since that time; Done over work; 12-16 hrs of sedentary work; Started getting Acid Peptic Trouble; Not taken any treatment for it; Later on diagnosed as a case of Peptic Ulcer; Operated first in 1981 for the same; Again in 1999;
Had 3 brothers; 2 died; 1 – due to Liver Cirrhosis & 1 Ca – Liver; Married in 1967; 1 Elder stays separate, never looks towards his illness; Feels left out from his family; Due to illness could not go in to the society; Feels rejected from the society.

Physical General Examination:
Weak, Emaciated, Sunken Face
Wt: 32kg
P: 100/min
BP: 110/70 mm of Hg
Tongue: Dry, denuded patches
Difficulty in Sitting & even Riding on Examination Table due to weakness
Looks: Anxious, Sadness, Depressed; Sighing off an on;

Clinical Examination:
GIT: Sunken Abdomen; Scars of previous Surgeries; Tenderness in epigastrium;

Investigations:
Barium meal study 22/301986
No evidence of hiatus hernia or reflux;
Stomach appears grossly dilated;
Persistence residue is seen in the stomach after 3 hours;
Suggestive of Pyloric Stenosis.

Rubrics:
1. Anguish, Pain in, Stomach
2. Sadness, Suicidal disposition, with
3. Sighing, Grief, with
4. Gen: Emaciation
5. Gen: Weakness, Nervous
6. Gen: Onion, Agg.
7. Stomach: Constriction, Pylorus, of
8. Stomach, Oppression
9. Stomach, Pain, Cold, Drinks, after, Agg.
10. Stomamch, Pain, Warm food, Amel.
11. Stomach, Spasms, Pylorus

Result of Repertorisation:

1. Ornithogalum: 13/11

2. Lycopodium: 10/6

3. Nux vomica: 10/6

Homoeopathic Management:

4 Nov 2006

Avoid Tobacco Give Oral Rehydration Sip by Sip

Ornithogalum 200…1 Dose Placebo… tds 10 days

7 Nov 2006

Felt better immediately
Two days consumed some diet
Looking fresh
But today, has consumed onion in diet & again got
3 forceful vomiting
Wt: 33Kg
P: 90/min

Ornithogalum 200…1 Dose repeated

14 Nov 2006
No vomiting thereafter
Looking much happy & fresh
Taking food 2-3 times a day
Wt: 35Kg
P:86/min

Placebo bid… 15 days

03/29/07
Patient never returned for follow-ups
Till yesterday enjoying food & his work
Since morning again got 3-4 forceful vomiting
Again induced due to onion utappa
Wt: 37Kg
P: 78/min
Comparatively looking much healthy

Ornithogalum 200…1 Dose
Placebo… tds 10 days

06/06/07
Patient never returned for follow-ups
Till yesterday enjoying food & his work
Since morning again got 2-3 forceful vomiting
Yesterday consumed Pav Bhaji
Wt: 39Kg
P: 74/min

Ornithogalum 200… 1 Dose
Placebo… tds 10 days

01/03/08
Patient never returned for follow-ups
His son met me & told that he is not having trouble;
That’s why not coming for the treatment.